Background to this inspection
Updated
3 October 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.
The inspection took place on 5 September 2017 and was announced. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure senior staff would be available in the office to assist with the inspection. This was the first inspection of this service since changes to the provider’s registration were made in May 2015.
This inspection was carried out by one adult social care 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.
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 the improvements they plan to make. We also reviewed the information that we had about the service including statutory notifications. Notifications are information about specific important events the service is legally required to send to us.
During the inspection, we spoke with eight people who received care from the service and four people’s relatives. We also spoke with the registered manager and three members of care staff.
We looked at four people’s care and support records. We also looked at records relating to the management of the service such as the staffing rota, policies, incident and accident records, recruitment and training records, meeting minutes and audit reports.
Updated
3 October 2017
We undertook an announced inspection of Butterfields Homecare on 5 September 2017. This was the first inspection of this service since changes to the provider’s registration were made in May 2015.
Butterfields Homecare provides personal care to people living in their own homes within the Taunton area and in a close proximity to the registered office. At the time of our inspection the service was providing personal care and support to 18 people. Some of these people only required a minimal level of personal care that fell within the regulation of the Care Quality Commission.
A registered manager was in post at the time of the inspection. 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.
The service had ensured that people felt safe that their care would be delivered as required. People spoke positively about the staff and said they were confident care would be delivered as planned. No concerns were raised about continuous lateness or missed care appointments. Staff had received training in how to identify and respond to suspected abuse and polices to guide staff on how to report concerns were available. There was sufficient staff on duty to meet people’s needs and there were systems used monitor people’s care delivery.
Staff felt they had sufficient time to meet people’s needs and said appointments were not rushed. Staff said the service ensured they had sufficient time between appointments to travel. Medicines were managed in a way that ensured people received them when they needed them. We identified some staff inconsistency in relation to some medicines recording which the registered manager was to going to address with staff.
People said they received care and support from trained staff and did not raise any concerns about staff competency. People received mixed but minimal levels of support in relation to eating and drinking, but told us staff supported them as needed. Staff were trained to ensure they understood the principles of the Mental Capacity Act 2005. No person using the service currently required authority from the Court of Protection to lawfully deprive them of their liberty in their own home.
The service had ensured that an effective induction and training programme was available for staff. This supported staff to provide effective care to people and staff commented that they felt they received sufficient training. Additionally, the service supported staff through a regular supervision and appraisal programme.
Where possible, the service had ensured continuity in care. This had allowed staff to build a relationship with people and their relatives. People gave very positive feedback about their care and we received the same level of feedback from people’s relatives. We reviewed a sample of compliment cards from people and relatives that had previously used the service which reflected the feedback we received. People were involved in planning and designing their care and staff understood the needs of the people they supported.
People said the service was responsive to their needs. People’s care records were personalised and people were actively involved in making choices and decisions in relation to their care. There was a system to ensure people’s needs were fully assessed prior to care packages being undertaken. The service had a system that ensured regular care reviews were completed. People and staff gave examples of how the service had been responsive in relation to unforeseen changes. The provider had a complaints procedure and people were given the required information they needed on how to complain if they wished to.
People and their relatives spoke positively about the management of the service. Staff felt supported by the registered manager and senior staff at the service. There were systems to obtain the views of staff and key messages were communicated to staff. Staff told us they felt listened to if they raised anything. There were auditing systems to monitor the quality of care provided together with the accuracy of records and documentation used by staff.