Archived: Guardian Homecare Brixham

Updated 31 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

One adult social care inspector, two assistant inspectors, and one Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience’s area of expertise was working in health and social care and providing care to a family member.

Service and service type:

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

Not everyone using Guardian Home Care Brixham receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The registered manager left in December 2018. The service did not have a manager registered with the Care Quality Commission. The manager had been in post for three weeks and was in the process of submitting their application to the CQC. 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.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that the manager would be in.

Inspection site visit activity started on 29 April 2019 and ended on 8 May 2019. We visited the office location on 29 April and 8 May 2019 to see the manager and office staff; meet with care staff, and to review care records and policies and procedures. We carried out phone calls to people and their relatives on 1, 2, and 3 May 2019. We carried out home visits to people on 1 May 2019.

What we did:

When planning our inspection, we looked at information we held about the service. This included notifications about significant incidents which the provider is required to inform us about by law. The provider had submitted a Provider Information Return (PIR). This is a form that asks to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with 25 people and four relatives by telephone. We also visited three people in their own homes. We spoke with the director of quality and governance, the manager, two co-ordinators, the administrator, and four care staff.

We looked at seven people’s care records, three staff recruitment files and other records relating to the management of the service including quality assurance.

Updated 31 May 2019

About the service: Guardian Home Care Brixham is a domiciliary care agency that was providing personal care to people in their homes in Brixham, Paignton, Torquay and Exeter. At the time of our inspection 208 people were using the service.

People’s experience of using this service:

Some care plans did not contain enough detail for staff to know how to deliver care effectively and consistently. Where people lacked capacity to make decisions about their care and support, the care plan did not contain evidence to show decisions had been made in the person’s best interests. Despite the lack of information in care plans, the majority of people told us staff knew them and met their needs on each visit.

At the time of our inspection, the manager had been in post for three weeks. The manager and senior management were already aware of the issues we identified. They knew what needed to be done to improve the service and had started work on this.

People felt safe and comfortable when staff visited them in their home. People were kept safe as potential risks had been assessed and managed.

There were enough staff to complete the planned visits. People were treated with kindness and compassion by staff. One person said, “The carers that come and see me are highly dedicated professionals, who care, do the job properly, and communicate with me”.

People’s needs were met by staff who had received regular training and support. People were treated with respect.

People were involved in making decisions about their care and supported to maintain their independence.

People and their relatives were asked for their views about the service. The most recent feedback results showed the majority of people were happy with the service they were receiving.

People and staff told us the service was improving and was well managed. People said, “The manager is very nice and takes notice of me, it’s been so much better this year” and “The manager is extremely wonderful, goes out of her way.” A staff member said, “I’m the most settled I’ve been in a long time”.

We found two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to need for consent and good governance. Details of action we have asked the provider to take can be found at the end of the full report.

More information is in the full report.

Rating at last inspection: This was the first inspection of this service.

Why we inspected: This was a planned inspection based on the date of registration.

Follow up: We will continue to monitor intelligence we receive about this service until we return to visit as part of our re-inspection programme. If we have any concerns, we may inspect sooner.