Archived: Bespoke Health & Social Care

Updated 7 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 15 December 2016 and was announced. We gave the service 48 hours' notice because the location was a domiciliary care agency and we wanted to ensure there was someone available in the office.

The inspection was carried out by one Inspector. Prior to the inspection, we reviewed information we held about the provider including reports from commissioners (who fund the care for some people) and notifications we had received. A notification is information about important events which the provider is required to send us by law.

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.

Due to the nature of peoples support needs we were not able to speak with any people using the service. However we spoke with eleven people’s relatives. We spoke with three support workers, a training coordinator, the clinical manager and the registered manager. We reviewed four care records, six MAR charts, quality audits, records of meetings and looked at the recruitment files of five members of staff.

Updated 7 March 2017

This announced inspection of Bespoke Health and Social Care was carried out on 15 December 2016.

Bespoke Health and Social Care provides support packages to children and adults in their own homes across the country. The head office which is the location we inspected is based in Nottingham City centre At the time of our inspection 69 people were using the service.

The service had a registered manager in place. 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.

People could not always be assured that their medicines were managed or administered safely as Medicines Administration Records (MAR) charts were not completed correctly or reviewed regularly.

People could not always be assured that where they did not have capacity to give informed consent their best interests and rights would be protected under the Mental Capacity Act (2005) (MCA ). MCA assessments were not in place for all people who required them. People’s wishes regarding their care and treatment were respected by staff. People provided consent to any care and treatment provided.

People told us they felt safe receiving care in their homes from staff of Bespoke Health and Social Care and did not have any concerns about the care they received. Staff knew how to protect people from harm and referrals were made to the appropriate authority when concerns were raised.

Risks to people’s safety were identified and managed, and assessments were carried out to identify how to minimise the risk of harm. For example in relation to falls or environmental risks.

People received care and support in a timely way and there were sufficient numbers of suitably qualified and experienced staff employed. Appropriate pre-employment checks were carried out before staff began work at Bespoke Health and Social Care.

People were supported by staff who received training and support to ensure they could meet people’s needs. Ongoing training and assessment for care staff was scheduled to help maintain their knowledge.

People were supported by staff to maintain healthy nutrition and hydration. People had access to healthcare professionals when required and staff followed their guidance to ensure people maintained good health.

People were treated with dignity and respect and their privacy was protected. People told us they had positive, caring relationships with staff. Where possible people were involved in making decisions about their care and support.

Staff understood people’s support needs and ensured they received personalised responsive care. People knew how to raise a complaint and were confident these would be listened to and acted on.

There was an open and transparent management culture at the service. People, their relatives and staff were encouraged to have their say on their experience of care. Some people experienced difficulty in contacting senior staff to raise issues about their care.

Quality monitoring systems were in place to identify areas for improvement and ensure these were actioned..