Yewtree Avenue

About the service

Yewtree Avenue (known as Blueboard Care Services) is a domiciliary care agency registered to provide personal care. At the time of the inspection 118 people were receiving care, 5 of whom lived in 2 supported living services the service managed.

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

Right Support

People had mixed views about staffing and our analysis showed improvements to call planning were required. The service told us they would address this. The service worked with other agencies to support people’s needs.

Right Care

Improvements had been made to medicines management since our last inspection and these were now managed safely. Similarly, improvements had been made to risk assessments and we found these were now being completed correctly and contained appropriate person-centred information.

There were systems in place to safeguard people from harm and abuse. Lessons were learned when things gone wrong. Infection control practice was robust as were recruitment measures.

Right culture

People had mixed views about the culture at the service, though staff were positive about the management. Similarly, there were mixed views about how the service engaged with people or relatives. Some told us they felt the service could improve in this regard.

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

Rating at last inspection (and what we found)

The last rating for this service was requires improvement (published 16 June 2021) and there were multiple breaches of regulation. 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 some improvements had been made but the service was still in breach of one regulation.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture and to follow up on action we told the provider to take at the last inspection.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified a continued breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Yewtree Avenue (known as Blueboard Care Services) is a domiciliary care agency registered to provide personal care. At the time of the inspection 88 people were receiving care.

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

Medicines were not managed safely. Medicine risk assessments did not contain enough information and medicine administration was not being quality assured satisfactorily. Risk assessments were not always completed correctly or contained contradictory information.

There were systems in place to safeguard people from abuse and lessons were learned when things went wrong. However, CQC were not always notified when allegations of abuse were made and one incident had not been recorded as such. People and relatives had mixed views about call times and staff having enough time to do their jobs.

Infection control measures were in place. Recruitment measures were robust.

There were mixed views about the communication from the service as well as about how it was managed.

People spoke positively about the care staff. The service worked with other agencies for the benefit of people using the service and we saw positive feedback about the service.

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 good (published 22 May 2020).

Why we inspected

We believed there was risk present at the service due to the number of factors including complaints we had received about the service in the past 12 months. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Yewtree Avenue, also known as Blueboard Care Services Ltd, is a domiciliary care agency. It provides personal care to people living in their own houses or flats. At the time of the inspection 59 people were using the service.

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

When asked the best thing about the service one person said, “Knowing that I will see a friendly face each day.” Another person said, “I just want to say thank you so much to them they're such a good care company.”

People using the service and their relatives had no concerns about people’s safety. Systems were in place to protect people from the risk of abuse. Risk assessments were completed to identify and manage risks to keep people safe. Staff were trained to support people to take their medicines. Measures were in place to protect people from the spread of infection. There were enough staff to meet people’s needs. Pre-employment checks were carried out to ensure staff were suitable to support people. There were procedures for responding to accidents and incidents.

The service carried out assessments of people’s needs prior to the provision of care and support to ensure their needs could be met by the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff supported people to eat and drink enough to meet their needs. The service worked with other agencies to promote people’s health, safety and well-being. Staff received training and support to ensure they were competent to carry out their role.

The service was respectful of people’s equality and diversity. However, we did not see how people who may identify as lesbian, gay, bi-sexual or transgender would be supported by the service. We have made a recommendation regarding best practice.

People received care and support from staff who were caring and compassionate. One person told us, “I am now housebound so; I look forward to my carers coming.” Staff treated people in a respectful manner maintaining their dignity and encouraging independence. Systems were in place to protect people’s right to confidentiality.

Care plans were person centred, included the individual needs of people, and were reviewed to reflect people’s changing needs. People received compassionate care at the end of their life. Complaints procedures were in place and people using the service were confident their concerns would be taken seriously and would be addressed.

People using the service, their relatives and staff, felt the service was well managed. There was an open and transparent culture. Quality assurance systems were in place to monitor the running of the service and the effectiveness of systems in place. Feedback was welcomed to ensure continuous improvement of the service.

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

Rating at last inspection

The rating at the last inspection was good (published 19 December 2017).

Why we inspected

This was a planned inspection based on our current methodology of inspection scheduling.

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.

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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is managed.

Risks had been identified and information had been included on how to mitigate risks to ensure people received safe care. Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and outside the organisation. Medicines were managed safely. Medicine records were completed accurately. Staff had been trained with medicines. Pre-employment checks had been carried out to ensure staff were fit and suitable to provide care and support to people safely. Staff told us they had time to provide person centred care and had enough staff to support people. There were systems in place to reduce the risk and spread of infection. Staff had been trained on infection control and were provided with personal protection equipment to ensure risks of infection were minimised when supporting people.

Staff had received training required to perform their roles effectively. People were cared for by staff who felt supported. Spot checks had been carried out to observe staff performance to ensure people received the required care and support. Staff had been trained on the Mental Capacity Act 2005 and knew the principles of the act. Assessments had been carried out using the MCA principles. People’s care and support needs were assessed regularly for effective outcomes. The service worked with health professionals if there were concerns about people’s health. Staff could identify the signs people gave when they were not feeling well and knew who to report to.

People had a positive relationship with staff. People and relatives told us that staff were caring. People’s privacy and dignity were respected by staff. People were involved with making decisions about their care.

Care plans were person centred and detailed people’s preferences, interests and support needs. People and relatives knew how to make complaints and staff were aware of how to manage complaints.

Staff told us the culture within the service was open and transparent and told us the service was well-led. People, relatives and staff were positive about the registered manager. People’s feedback was sought from surveys and reviews meetings.