Background to this inspection
Updated
22 April 2020
The inspection
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.
Inspection team
This was an announced inspection which was carried out by an adult social care inspector and took place on 10 and 11 March 2020.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection site visit activity started on 10 March 2020 and ended on 11 March 2020. We undertook home visits and made a telephone call to a relative on 10 March 2020. We attended the office on 11 March to see the registered manager and office staff; to review care records; policies and procedures and records relating to the management of the service.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
During our inspection we visited the homes of two people (who were unable to speak with us due to their disabilities) and spoke with their relatives. Another relative provided feedback about the service to us via telephone. We spoke with two care workers, a consultant providing support to the provider and the registered manager. We reviewed four care records, two staff records and records relating to the management of the service.
We requested additional evidence to be sent to us after our inspection. This was received, and the information was used to in this report.
Updated
22 April 2020
About the service:
Better Life Care provides personal care to children, younger adults and older people with complex health needs. The service covers Slough and the surrounding areas. At the time of our visit it was providing personal care to nine people.
People’s experience of using this service and what we found:
Relatives acting on behalf of people, spoke about the caring nature of the service. A relative commented, “The registered manager is very caring. When I was in hospital, they made sure (person’s) care was sorted so I could just focus on getting better.”
People were kept safe from abuse. Staff were aware of their responsibilities to keep people safe and had attended the relevant training. Risk management plans were in place in mitigate risks to peoples’ health and welfare. There were enough suitable staff to meet people’s care and support needs. There were safe management of medicines and staff’s care practices ensured people were protected from the risk of infection.
People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests; as the policies and systems in the service did support this practice. We found the service acted in accordance with the Mental Capacity Act 2015.
Peoples’ care and support needs were fully assessed before they joined the service. This ensured the service could provide effective care. Staff were appropriately inducted, trained and supervised. Consent was obtained before people received care. Staff had a good knowledge and understanding of peoples’ dietary needs. There was collaborative work between the service and other health and social care professionals. This made sure people achieved good health outcomes.
Assessments of peoples’ care and support needs focused on peoples’ specific needs and preferences. However, peoples' preferences for end of life care were not captured. We have made a recommendation about this.
The service met the requirements of the Accessible Information Standard (AIS). This meant people with disabilities or sensory impairment were given information in ways that met their communication needs. The service supported people to participate in social activities they enjoy. Relatives acting on peoples’ behalf told us they knew how to raise complaints. Appropriate actions were taken by the service in response to complaints received and this was used to promote learning.
Relatives acting on people’s behalf gave positive feedback about the service. A relative commented, “I am over happy. I would not change them (the service) for anything.” Quality assurance systems were robust. This was continually monitored and reviewed. The registered manager continued to work in partnership with community stakeholders and local authorities to ensure people’s care and support needs were met.
Rating at last inspection and update: The last rating for this service was requires improvement (published 10 January 2019). 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 Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk