Archived: Better Healthcare Services

Updated 9 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 1 inspector. An Expert by Experience also spoke to relatives on the telephone about their experience of the care provided. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider would be able support the inspection. Inspection activity started on 19 June 2023 and ended on 27 June 2023. We visited the location’s office on 26 and 27 June 2023.

What we did before the 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person who used the service. We spoke with 6 relatives about their experience of the care provided. We spoke with 6 staff including, care workers, a senior care assistant, the field care supervisor, the care coordinator and the manager. We reviewed 6 people's care records. We looked at 3 staff files in relation to recruitment practices. We reviewed various records relating to the management of the service including training records, safety checks, incidents and accidents.

Updated 9 September 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Better Healthcare Services is a domiciliary care service registered to provide the regulated activities of personal care and treatment of disease, disorder or injury to people living in their own homes. Not everyone who used the service received regulated activities. CQC only inspects where people receive regulated activities. For people who receive care from this provider, this is help with tasks related to personal hygiene, eating and treatment of disease, disorder or injury which should be overseen by an appropriate health professional. Where they do we also consider any wider social care provided. At the time of our inspection, there were 24 people receiving regulated activities.

People’s experience of using this service and what we found

Right Support

People did not always have current care plans to meet their health and well-being needs and manage risks. The provider did not ensure people always received their medicines safely.

Right Care

The provider had not ensured all safeguarding concerns were shared with CQC. People did not always receive their care at the right time or for the right duration, and the provider had not monitored this. People did not always have their treatment effectively overseen by a medical practitioner, which increased health-related risks to them.

Right Culture

There was not always a positive culture in the service, as staff did not always feel well supported by the provider. Lessons could not always be learnt from accidents and incidents as these were not always recorded. There were no established systems and processes for the provider to maintain quality standards and to continuously improve the service people received. However, the staff did feel supported by the manager, and there were systems in place to seek regular feedback from people, relatives and staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 2 April 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Better Healthcare Services on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to people’s safety and good governance at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will work alongside the provider and local authority to monitor the service and continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.