Background to this inspection
Updated
21 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The office visit took place on 14 February 2018 and was announced. We told the provider we were coming so they could arrange to be there for us to review their care records and to obtain information about people and staff so we could speak with them after our visit. This visit was a fully comprehensive announced inspection and completed by one inspector.
We looked at the information we held about the service and the provider. This included statutory notifications the provider had sent us. Statutory notifications are reports the provider is required by law to send us, to inform us about incidents that have happened at the service, such as an accident or a serious injury. Prior to this inspection visit, we received information that suggested staff were not always giving medicines and did not stay for the specified times. We looked at this during this inspection.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR was an accurate reflection of what we found during our visit.
During the inspection visit on 14 February 2018 we spoke with the registered manager. They provided us with a list of 10 people and relatives who they confirmed had given permission to speak with us. This was so we could gain their views about the service they received. Following our visit, we spoke by telephone with one person who received the service and four relatives. We spoke by telephone with two care staff about what it was like to work for Balm Care.
We reviewed care plans for two people including their daily records to see how their care and support was planned and delivered. We looked at other records related to people's care and how the service operated. This included the providers call monitoring systems, medicine records, complaints, staff training records and the service's quality records. Quality records included two recruitment records, provider audits and notes of staff meetings and staff supervisions, and records of observed practice.
Updated
21 March 2018
Balm Care is a domiciliary care agency that provides personal care to people living in their own houses and flats in the community. Balm Care provides a service to people living with dementia, learning disabilities or autistic spectrum disorder, mental health, older people, sensory impairment and physical disabilities. At the time of our inspection visit they provided a service to 23 people and employed 17 care staff.
At the last inspection in April 2015, the service was rated Good. At this inspection we found the overall rating remains Good.
Since our last inspection we have reviewed and refined our assessment framework, which was published in October 2017. For this inspection, we have inspected all key questions under the new framework, and also reviewed the previous key questions to make sure all areas were inspected to validate the ratings.
The office visit took place on 14 February 2018 and was announced. We told the provider we were coming so they could arrange to be there and so they could contact people, to seek their permission for us to speak with them about their experience of using this service.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
There were procedures to keep people safe and manage identified risks to peoples care. People felt safe using the service and staff understood how to protect people from abuse and harm.
People who required support to take medicines received these mostly from family members. However where staff administered medicines, staff were trained and assessed as competent to do so. The provider’s recruitment process was thorough and ensured pre-employment checks were made, prior to staff starting work, to ensure they were suitable to support people who used the service.
Staff used protective clothing, such as disposable gloves and aprons when providing personal care, to reduce the risk of infection being passed from one person to another.
People had an assessment of care completed before they used the service to make sure staff could meet people’s care and support needs. People said care staff usually arrived around the time expected and stayed long enough to provide the care outlined in their care plan. Care plans provided information for staff about people’s care needs and the details of what they needed to do on each call.
The registered manager and staff followed the principles of the Mental Capacity Act (MCA). Staff respected decisions people made about their care and gained people’s consent before they provided any care or support.
People told us they received care from staff who knew them well and from staff who were kind, caring and considerate to their needs. People said staff treated them with dignity and respect and relatives were confident their relations were looked after well. Staff knew the people they visited very well and spoke about people in a caring and considerate manner.
People’s care needs were regularly reviewed. The registered manager and office staff were in regular contact with people, or their relatives, to check the care provided was what people needed and expected. People knew how to complain and information about making a complaint was available for people when they started using the service. People knew who the managers were and felt they listened to them and dealt with any concerns they had.
Staff felt supported to do their work effectively and said the managers and provider were approachable and available. There was an ‘out of hours’ on call system, which ensured support and advice was always available for staff.
The provider's quality monitoring systems included asking people for their views about the quality of the service. The management team regularly checked people received the care they needed by observing staff during visits and through feedback from people and staff.