Background to this inspection
Updated
16 June 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was conducted by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Best At Home Domiciliary Care Services Ltd is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection the service did not have a manager registered with the CQC. A new manager was appointed in May 2023, and they have submitted an application to be registered with us.
Notice of inspection
We gave the service 48 hours of the inspection. This was because we needed to be sure that the managers would be in their office to support the inspection.
Inspection activity started on 31 May 2023 and ended on 5 June 2023. We visited the provider’s offices on the last day of this inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke in-person with various managers during our site visit including, the operations manager, the quality assurance and compliance manager and the nominated individual (The nominated individual is responsible for supervising the management of the service on behalf of the provider). We also received telephone and/or email feedback from various people in relation to their experiences of using or working with or for Best At Home Domiciliary Care Services Ltd. This included a person who received a care at home service, 8 relatives, and 8 care staff who worked for this provider.
Records we looked at as part of this inspection included, 6 people’s care plans, 6 staff files in relation to their recruitment, multiple medicines records, and a variety of other documents relating to the providers overall management and governance systems.
After we visited the provider’s offices, we continued to seek clarification from them to validate evidence found. We requested the provider send us additional evidence after our inspection in relation to staff training, satisfaction surveys completed by people who received a service, their relatives and care staff, and the provider infection prevention and control policy.
Updated
16 June 2023
About the service
Best At Home Domiciliary Care Services Ltd is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection 33 older people were receiving personal care at home from this provider. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
People and their relatives were mostly positive about the quality and safety of the personal care they or their loved ones received. People agreed the service was moving in the right direction and had significantly improved in the last 12 months.
At our last inspection we found the provider had failed to ensure; staff call visits were always well-coordinated, we were notified without delay about the occurrence of significant incidents that adversely affected the health and wellbeing of people they supported, and they appropriately maintained and audited medicines records.
At this inspection we found enough improvements had been made. People now received consistently safe, good-quality personal care from the same group of punctual staff who were familiar with their needs and daily routines. The provider had also introduced a range of electronic systems to monitor staffs time keeping, their record keeping and medicines management and had created a new quality assurance and compliance manager role to oversee the effectiveness of the providers new oversight and scrutiny systems.
People continued to be protected against the risk of avoidable harm by staff who knew how to keep them safe. The fitness and suitability of prospective new care staff was thoroughly assessed and checked. People received their prescribed medicines as and when they should. People were confident any concerns they raised would be listened to and dealt with appropriately. Staff followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Most people and staff were complimentary about the way the office-based managers now led the service, and how approachable they all were. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. The provider promoted an open and inclusive culture which sought the views of people, their relatives, and staff. People had up to date, detailed, person-centred care plans in place, which were routinely assessed, monitored, and reviewed. Staff had the right levels of training and support to deliver safe care to the people they supported. People were treated with dignity and respect by staff who they typically described as “attentive” and “kind.” The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people's packages of care at home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 26 May 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We conducted an announced comprehensive inspection of this service in April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve how they coordinated staff call visits, managed notifiable incidents they were required to send the CQC and how they maintained and audited medicines records.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Best At Home Domiciliary Care Services Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect. If we receive any concerning information, we may inspect sooner.