This inspection took place on the 11 April 2018 and was announced. This was the service’s first ratings inspection since it was registered in 2015. Bridge-it Options Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people, younger adults, people living with dementia, people with a physical disability and a learning disability. The service also provided support to people who required ‘live in’ care. 14 people were receiving personal care, visits to people’s homes varied from one visit per day to four visits per day.
Not everyone using Bridge-it Options Ltd 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 service had a registered manager in post. 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. The registered manager was on leave when we inspected but the registered provider was available throughout our inspection.
Medicines were not managed safely. People’s medicines were not recorded in full on their medicine administration records. This meant staff did not know what medicines they were administering and there was no accurate record of what medicines people had been given.
Staff were not recruited safely. The provider had not asked for full employment histories of all of their staff. References had not been checked against employment records as this was not possible with no record of employment. The provider had completed a check with the disclosure and barring (DBS) service prior to employment. A DBS check helps employers make safer recruitment decisions by identifying applicants who may be unsuitable to work with people made vulnerable by their circumstances.
There were not robust auditing systems in place to make sure the service was monitoring the quality and safety of the service. This meant that the provider did not have oversight of shortfalls that we found during our inspection. The lack of quality monitoring meant that some records at the service required improvement.
People were able to have support with meal times. They told us meal times were not hurried and they had the support they required. We found not all staff had received food hygiene training to make sure they were fully aware of food handling and preparation. The provider told us they would make sure staff had the training they needed.
Risks had been assessed and care plans were person-centred. There was guidance for staff to follow to know what people’s needs were. Confidential information was kept secure. People’s care plans were kept in their homes so they could access them at any time.
Staff were aware of the signs of abuse and knew what action to take to report any concerns. They were confident their concerns would be dealt with by the service. Staff had regular team meetings and supervision with their supervisors.
When new people started receiving care and support the senior management escorted the member of staff to the person’s house so that they could do a formal introduction. People told us staff respected their dignity and privacy.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People had consented to their care and were involved in regular reviews of their support. As care and support plans were stored in people’s homes, they could see them whenever they wanted.
Complaints were recorded and managed according to the provider’s policy. The service captured compliments they were sent about the care people had received.
Senior management were visible, they often did visits to people so they knew what people's needs were. Staff told us they felt supported by the management.
The service worked with other agencies to make sure people got the care they needed at the time it was needed.
We have found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.