The Care Quality Commission
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  • Homecare service

Archived: Better Healthcare Services (Brighton)

Overall: Good read more about inspection ratings

Bostel House, 37 West Street, Brighton, East Sussex, BN1 2RE (01273) 203999

Provided and run by:
Better Healthcare Services Ltd

Important: This service is now registered at a different address - see new profile

All Inspections

10 January 2017

During a routine inspection

The inspection took place on the 10 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

Better Healthcare Services (Brighton) is a domiciliary care service which provides personal care and support services for a range of people living in their own homes. At the time of our inspection approximately 77 people were receiving a service.

The service had a registered manager. 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.

At the last inspection in November 2015 we identified areas of practice that needed to improve these included, medication administration records (MAR) had not always been completed accurately, procedures in relation to disclosure and barring (DBS) checks had not always been followed, concerns were raised in relation to communication between staff, records of spot checks had not routinely been completed, results and analysis of feedback questionnaires had not taken place and staff meetings were held irregularly. At this inspection on 10 January 2017 we found that improvements had been made and the overall rating for this service has been revised to good.

The experiences of people were positive. People told us they felt safe, that staff were kind and the care they received was good. One person told us, “They are absolutely excellent. They are brilliant and I feel very safe with them”. A relative added, “They are just marvellous. I know [my relative] is in safe hands with these people”.

The service was very flexible and responsive to people’s individual needs and preferences. Staff found innovative and creative ways to enable people to have an enhanced sense of wellbeing and exceptional quality of life. People told us that staff had outstanding skills, and had an excellent understanding of their needs. Healthcare professionals told us that the service was focused on providing person centred care and that it achieved exceptional results. One healthcare professional told us, “They have given [person] a level of care and quality of life that is exceptional. They have allowed them to access a normal life”.

People told us that staff were friendly and caring. One relative told us, “They are really brilliant. My relative really looks forward to them [the care workers] coming, because he has such a good rapport with them”. People were happy with the care they received, and said they saw regular consistent staff that knew them well and treated them with kindness. One person told us, “I’m very happy, it’s usually the same group of people who come all the time and they’re so cheerful that I look forward to seeing them”.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access to health care services when needed.

Risks to people were assessed and monitored to ensure action was taken to avoid accidents and the deterioration of people’s health. The service had recruited a sufficient number of suitably qualified staff to meet people’s needs. Recruitment practice was robust and protected people from the risk of receiving support from staff who were unsuitable.

The service considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

Staff were skilled and felt fully supported by the provider to undertake their roles. They were given training updates, supervision and development opportunities. One member of staff told us “The induction I had gave me the experience and the training gave me the knowledge”.

People and their relatives were given information on how to make a complaint. Feedback from people was asked for and responded to. One person told “I think there is something in there about how to complain, but to be honest, I’m not interested, because I have no complaints”.

The service was well led and had good leadership and direction from the provider. People, relatives and health professionals were complimentary of the management of the service. A relative said, “I certainly wouldn’t want another company, because overall they are excellent”. Staff felt fully supported by the provider to undertake their roles. There were quality assurance systems in place to ensure a high quality of care and support was provided.

11 & 12 November 2015

During a routine inspection

We undertook an announced inspection of Better Healthcare Services (Brighton) on 11 & 12 November 2015. We told the registered manager two days before our visit that we would be coming. We did this because they were sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure they would be in.

Better Healthcare Services (Brighton) is registered to support people in their own homes with personal care and domestic duties. At the time of our inspection forty nine people were receiving a personal care service. People were able to tell us about the care and support that they received. Some people were living with illness associated with advancing age or other long-term health related condition. Some people lived reasonably independent lives but required support to maintain this independence.

There is a registered manager at the service. 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 was last inspected on 26 June 2013 and since then it has grown so that they now provide many more hours of care to more people. As the service had developed further staff had been employed. Although systems were in place to support and protect people these needed to be established and embedded into practice to ensure the service can continue to develop and support people appropriately.

The provider had policies and procedures in place for the recruitment of new staff but these were not consistently followed. All the relevant safety checks were completed but we heard about how a staff member was permitted to attend calls before their DBS confirmation was received. The registered manager took action to address this.

Staff knew about people and the medicines they required. However, systems were not yet established to ensure the administration of medicines were always recorded in a safe and consistent way.

Though formal feedback was obtained from people and their relatives it was not collected and collated to provide an analysis of the responses and take learning from it. This meant the provider did not have full oversight of where the service could develop and improve.

All staff were committed to providing a service that met people’s individual needs and preferences. People were complimentary of the staff and the care they received from them.

Staff knew people and they had a good understanding of how to support them. Staff understood people’s specific needs. Staff had built up relationships with people and were familiar with their wishes and preferences. Continuity of support had resulted in the building of people’s confidence in their care staff. One member of staff said, ““I work with a regular client group on a daily basis. That’s what makes the job so rewarding, it’s how I build trust into my work with people.”

Potential risks to people in their everyday lives had been identified and had been assessed in relation to the impact it had on people.

People received care and support from dedicated staff who were appropriately trained, confident and motivated to meet their individual needs. A person told us, “They [staff] are trained and experienced and the organisation is much better than some others in that regard, they’re very good indeed.”

Staff had a good understanding of safeguarding procedures and what steps they would take if someone was at risk of abuse or harm.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of the principles of the MCA and how this might affect the care they provided to people. People had their capacity assessed and they were asked to provide their consent to the support being provided.

Staff were aware of their responsibilities regarding reporting any accidents and incidents. A system was in place to record accidents and incidents.

People’s health was monitored and when it was necessary, health care professionals were involved to make sure people remained as healthy as possible. People were encouraged and supported to have a nutritious and healthy diet.

Positive and caring relationships had been developed between staff and people who used the agency. People were involved in the planning and reviewing of their care and making decisions about what care they wanted. A member of said told us, “If I have a problem I speak to the office who listen and do something. For example, I had a client who wanted some help and advice accessing a day centre. I spoke with the care manager and they followed it up with others, including the key family members.” People were treated with dignity and respect by staff who understood the importance of this.

People were provided with care that was responsive to their changing needs and staff were aware of people’s individual care needs. People felt able to make a complaint if they wanted to and knew how to do so.

There was an established management team and staff had clear roles and responsibilities. Staff and people were supported by a registered manager who was committed to providing a high quality service that met people’s needs.

26 June 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives, visitors and the staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.

Is it safe?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw care plans that were sufficiently detailed to allow care worker to deliver safe and responsive care. People told us that they were happy with the care and support that they received. A person who used the service said, 'It's just me and my carer here and they have been wonderful, ensuring I can stay in my own home. I don't want to be anywhere else.'

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Recruitment practices were safe. Staff had the knowledge, skills and understanding to deliver safe and effective care.

Is it effective?

The provider had clear procedures to obtain consent that are followed in practice, monitored and reviewed. The manager told us, 'We consider people's consent at every review, or as and when people's needs changed'.

Care plans were personalised and included information on the individuals life history and identity. This allowed for staff to provide care that was individual to that person.

Training records confirmed that staff had received the appropriate skills and knowledge to safely deliver care and support to people.

Is it caring?

Staff spoke with compassion and kindness for the people they supported. People were supported by committed and attentive staff. Observations of care found that people were treated with dignity and respect. A relative told us, 'I have found the whole process of having Better Healthcare provide care for [my relative] most satisfactory.'

It is responsive?

There was a complaints policy and procedure in place if people or their representatives were unhappy, which was monitored by the provider. People told us that they felt happy and confident approaching staff with any concerns.

Is it well-led?

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. We had the following response from a family member of a person who used the service, 'The manager it seems is always available. What's more, he phones regularly to get our experience.'

31 May 2013

During a routine inspection

We spoke with the manager, two members of staff, two people who used the service and two family members. We looked at supporting care documentation and staff documentation. This told us before people had received any care or treatment they had been asked for their consent and the organisation's staff had acted in accordance with their wishes.

People had been involved in making decisions about their care and treatment. During our inspection we found that people's needs were comprehensively assessed before and during the delivery of care. One person who we spoke with told us 'I am very pleased at the care my family membermother in law is receiving'. The planning and delivery of care met people's individual needs. Care plans were written in partnership with people who used the service.

We found that the service had an effective safeguarding policy with clear procedures in place. We found that the staff had knowledge of the procedures to follow. One care worker told us "I am alert to the signs of abuse, I wouldn't hesitate to respond when it was needed".

The service operated effective recruitment procedures to ensure that staff were suitable for their role, provided appropriate training, supervision and appraisals.

Better Healthcare Services had effective systems in place to monitor and assess the quality of the service.

3 May 2012

During a routine inspection

As part of our visit we spoke with the manager of the service who explained to us the systems the agency had in place. We were unable to speak with anyone who used the agency because at that time it had not started providing a service to people living in their own home's.