Brisen Company Limited

Updated 7 March 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Inspection team

This inspection was carried out by 3 inspectors and 2 Experts 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.

Service and service type

Brisen Company Limited is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours' notice of the inspection as we needed to be sure that the registered manager would be in the office to support the inspection. This inspection site visit took place on 07 and 14 December 2023 and was announced. The inspection activity completed on 16 January 2024.

What we did before the inspection

We checked the information we had about the service including notifications they had sent us. A notification is information about incidents or events that providers are required to inform us about. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 4 people and 8 relatives to seek their views about the service. We spoke with 5 members of care staff, the care manager, and the registered manager. We reviewed records, including the care records of 8 people using the service and recruitment files and training records of 3 staff members. We also looked at records related to the management of the service such as quality audits, accident and incident, and policies and procedures.

Updated 7 March 2024

Brisen Company Limited is a domiciliary care agency. It provides personal care to people living in their own homes as well as a reablement service. This is short term care, normally up to six weeks, and therefore the numbers of people receiving support vary on a weekly basis. At the time of the inspection there were 11 people receiving personal care and no-one was receiving the reablement service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People's experience of using this service

Risk assessments and risk management plans were not always in place or were not adequate. People's medicines were not always safely managed. There was not a robust safeguarding process in place to keep people safe. Appropriate recruitment checks were not carried out before staff joined the service. There was a system in place to log and investigate accidents and incidents, but these were not analysed, and any learning was not disseminated to staff. Records showed people’s independence was not always promoted.

Staff had not received adequate training. Staff were not always supported through regular supervision. Governance systems were not effective at identifying and reducing risks to people's safety. There was a lack of oversight and effective leadership of the service.

People or their relatives were involved in planning their care and support and their care plans but these were not reviewed regularly. People’s privacy, dignity and independence was maintained. People were protected from the risk of infection. People’s end of life care wishes was recorded in their care files. Staff were deployed to meet people's needs in a timely manner. People were supported to eat and drink. The provider had not received any complaints since the last inspection. Regular feedback had been sought from people about the service.

Rating:

The last rating of the service was Inadequate (published on 06 October 2022) when we carried out a comprehensive inspection.

At our last inspection we found breaches of the regulations in relation to regulations 9 (person-centred care), 10 (dignity and respect), 12 (safe care and treatment), 13 (safeguarding service users from abuse and improper treatment), 14 (Nutrition), 16 (receiving and acting on complaints), 17 (good governance), 18 (staffing) and 19 (recruitment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We had told the provider what action they needed to take to ensure the safety of people who used the service. At this inspection we found that the provider had made some improvement but remained in breach of regulations.

Why we inspected:

This inspection was carried out to follow up on action we told the provider to take at the last inspection. At this inspection we found that the provider had made some improvement but still remained in breach of regulations 9 (person-centred care), 12 (safe care and treatment), 13 (safeguarding service users from abuse and improper treatment), 18 (staffing) and 19 (recruitment) and 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We identified breaches in relation to lack of risks assessments, risk management plans, detailed care plans, medicines management, safeguarding, staffing, recruitment practice. There were no robust systems in place to assess and monitor the quality of the service provided. There was a lack of effective oversight and leadership of the service.

Enforcement:

This service has been in Special Measures since August 2022. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall; therefore, this service is no longer in Special Measures.

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.

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

Follow up We will meet with the provide to discuss how they will make changes to ensure they improve their rating to at least good. 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 with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.