Archived: Beeches Homecare - Corsham

We returned to the agency to check whether improvements had been made. We were pleased to see progress in both of these areas. The provider was auditing all recruitment files and had introduced recruitment checklists so that a clear audit trail of the process could be seen. They had not however produced a recruitment policy which would outline the procedure for all staff responsible for recruitment.

There were improved systems in place to monitor quality and safety. The provider was regularly capturing feedback from people who used the service. Regular reviews were taking place of care files to ensure they were complete and up to date. The provider had recently installed a new software system which allowed them to monitor performance in a number of areas, although its full capability had not yet been tested.

We issued a warning notice which required the agency to take immediate action to address this area of concern. We returned to the agency to see if improvements had been made. The registered provider and the office manager were not available on the day of our visit. We spoke with a senior employee who was covering for the office manager. We looked at training and supervision records and other documents, including the staff handbook. We spoke with four staff over the telephone. Three out of the four staff told us that they felt well supported with training and supervision, whilst one staff member felt that it was inadequate.

We saw that new systems had been introduced so that training and supervision could be better monitored and planned. However, scheduled meetings were not consistently taking place. Training records were incomplete and there was no training plan to show how shortfalls were to be addressed.

We requested information to be sent to us following our inspection and we met with the registered provider to discuss our findings. They advised that we had been provided with inaccurate information on the day of our inspection and provided us with further information, which we took into account when making our judgement but this did not fully mitigate our concerns.

We spoke by telephone with three people who used the service. Feedback was positive. One relative told us, 'they are quite reliable; they do everything I can't do'. Another person told us, 'I am very satisfied, they are very reliable, nice, kind and thoughtful people'.

The provider had taken steps to ensure that support plans were regularly reviewed so that they were fit for purpose, although this piece of work was not complete.

Recruitment procedures had been reviewed in order to ensure consistent practice but we found examples of incomplete pre- employment checks. Although these did not relate to recent appointments, the provider had not audited staff files to ensure that all of the necessary documentation was in place. We found, as previously, that staff did not consistently receive supervision, appraisal or regular training in essential subjects.

Systems to monitor quality and safety continued to be inadequate and we had ongoing concerns that the registered provider was not fulfilling their managerial duties.

People told us that they were treated with dignity and respect. People had copies of their care plans but we saw little evidence that they had been involved in developing or reviewing these plans. We found little evidence that people had been contacted by the agency to hear their views first hand.

People's needs had been assessed and support plans had been developed to meet these needs. Care plans were task orientated and were not person centred. Records showed that people received the care prescribed in their plans. People told us they felt safe in the company of care staff and they felt able to raise any concerns with the agency. Staff were provided with information and training so that they knew how to report concerns of abuse.

Staff told us they were well supported in their work but records showed that some staff were not up to date with essential training. and had not received regular supervision or appraisal. Systems to monitor safety and quality and safety were inadequate and we saw no evidence of regular audit.