Archived: South Birmingham Home Care Also known as Hall Green/Selly Oak Home Care Service

South Birmingham Home Care is a domiciliary care agency providing personal care to people living in their own homes in the community. It provides a service to older and younger adults and some people received an ‘enablement’ package of support of up to six weeks. At the time of the inspection the service was supporting 170 people.

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 and what we found

Following the last inspection, a number of improvements had been made in response to the concerns raised. We saw a variety of systems and processes in place to audit the quality and safety of the service and where these identified the need for improvements, they were quickly acted on. The views of people and staff were sought regarding the effectiveness of the service and people and staff felt listened to.

People, relatives and staff spoke positively of the service and considered it to be well led. Staff felt supported and listened to and were proud to work for the provider. People’s views of the service were regularly sought and where amendments to care packages were required, action was taken. There were a number of audits in place to provide the registered manager with oversight of the service.

People felt safe when supported by staff. Staff had received training in how to recognise abuse and were aware of their responsibilities to report and act on any concerns. Staff were aware of the risks to people and how to support them safely. Systems were in place to review the risks to people and keep staff up to date regarding any changes in people’s care needs.

People were supported by a consistent group of staff who knew them well and usually turned up on time. For those who required support with their medication, this was provided by trained staff. Staff had received training in protecting people by the prevention and control of infection and had access to personal protective equipment. Systems were in place to ensure lessons were learnt and improvements were made where things went wrong.

Staff felt well trained and supported in their role. They were provided with training and support to enable them to meet the needs of the people they care for. People were involved in the planning and review of their care. Where appropriate, staff supported people to eat and drink enough to maintain a balanced diet. Staff were aware of people’s particular healthcare needs and helped them seek medical assistance where required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were complimentary of the staff who supported them and spoke warmly of the care received and acts of kindness displayed by staff. Staff had developed positive relationships with the people they supported and where possible, encouraged them to be as independent as possible. Staff treated people with dignity and respect and supported them to express their views and be actively involved in decisions about their care and support.

People were happy with the service they received and considered staff to know them well. People had no complaints about the service, but where concerns had been raised, they had been dealt with appropriately.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 7 March 2019).

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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.

People told us that they felt safe using the service and staff were confident that any concerns would be dealt with appropriately. The provider had an electronic call monitoring system where staff logged in and out of their calls, which enabled care staff visits and punctuality to be monitored. Staff followed infection control guidance and had access to personal protective equipment. Improvements were needed in how the provider assessed risks to people as there were inconsistences across the records we reviewed.

People who used the service told us that staff were kind and caring and treated them with dignity and respect. People had regular care staff who knew how they liked to be supported. We saw the provider had contacted the necessary health and social care professionals when people's health deteriorated.

The provider had a system in place for responding to complaints. People knew who to contact if they had any concerns.

The provider continued to promote an open and honest culture and people told us they were happy with the management of the service. Staff spoke positively about the support they received.

Although people told us that they did not have any concerns with how they were supported with their medicines, we continued to see that improvement was needed to ensure practice was in line with the National Institute for Health and Care Excellence guidance.

The governance systems in place to monitor the quality and safety of care provided had not been effective leaving people at risk of receiving unsafe care. Some improvements were needed around the auditing and reviewing of people's care documents as issues that we found had not always been picked up.

We found a breach of regulation in relation to the systems in place to monitor and improve the quality of the service. You can see what action we told the provider to take at the end of the full version of this report.

More information is in Detailed Findings below.

Rating at last inspection: Requires Improvement (report published 9 August 2017).

About the service: South Birmingham Home Care is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and younger adults. Some people receive an ‘enablement’ package of up to six weeks. At the time of the inspection they were supporting 84 people.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will ask the provider following this report being published to tell us how they will make changes to ensure they improve the rating of the service to at least Good. We will revisit the service in the future to check if improvements have been made.

There was a registered manager in place who was present throughout our inspection. 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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they were supported to feel safe and comfortable using the service. Staff we spoke with were aware of their responsibilities to promptly raise any safeguarding concerns they identified to help protect people using the service.

Systems were not robust for monitoring and reflecting how people received support that met their needs. Records were not robust in relation to the support people required and received however to help manage their risks. This posed a risk that people would not be supported in line with their needs. People described how staff helped them to manage their risks and staff demonstrated a general understanding in such areas.

People were satisfied that they received their calls on time and suitable action was taken to prevent late and missed calls. The registered provider continued to undertake safe recruitment practices to ensure that people were supported by staff who were suitable.

Staff told us that they felt confident providing support to people with their medicines. We found however that people were not supported with this task in line with current good practice guidance. This did not ensure that people always received safe support with their medicines.

People spoke positively about the support they received from staff and how this met their needs. Staff told us that they felt supported and equipped for their roles, although aspects of training had been delayed.

People confirmed that staff followed their choices and wishes. Staff had not received training in relation to the Mental Capacity Act (2005), the registered manager assured us that guidance would be provided in this area to address any shortfalls in staff knowledge. People were satisfied with the support they received with meal preparation, although records did not always reflect this positive practice. People were supported to access further healthcare support to promote their health.

People told us that they were treated with respect by staff who were kind and caring. People were involved in planning their care and described the positive outcomes and experience of using the service.

The registered provider had a formal complaints process. People told us that they had no reason to submit a formal complaint about the service, although they would feel comfortable doing so if necessary.

People and staff described the service positively. Records and systems were not always robust, and information available to the service was not always used to ensure and drive the quality and safety of the service.

People's needs were assessed before they received a service. Information about people's needs and support required was available to care staff before they provided assistance. This helped to keep people safe.

We spoke with seven people or their relatives about the service. Amongst their comments were: "They do everything to help you', "They are very respectful and patient', "I got on the mend faster that I would have without them."

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Care staff had supervision, training and support whilst providing a service and this helped to keep people safe. The provider had appropriate systems in place to ensure that the quality of the service could be measured.

Information had been collected from people about their needs before receiving a service. However all the people we spoke with said that they had received no written information about the service before it started. Home care organisers told them about the service after it had started.

We found that people received appropriate care from care staff that understood their needs. However, people experienced a large number of different carers providing their care. This meant that people did not receive the continuity of care they wanted. A new computer scheduling and monitoring system had started to be used when we visited. We were advised that this system should improve the scheduling care in the future.

There was appropriate information recorded about people's nutrition and hydration. People we spoke with felt safe with how the care was provided. There was appropriate written information about people's care and this was kept securely.