This inspection took place on 30 September and 9 October 2015 and was announced.
Brighton and Hove Home Care is a domiciliary care agency and provides personal care and support for adults living in their own home in the Brighton and Hove area. Care is provided to adults, but predominantly to older people, including people who may have a physical disability, a learning disability, sensory loss, mental health problems or people living with dementia.This is a responsive short-term service where people have care for up to six weeks, but on average people receive care for a period of up to four weeks. This is a reablement service for people who need support to regain their independence, but do not require any clinical care. Care and support is also provided to people who live in an extra care housing scheme, and for a small number of people who have complex care needs and receive long term care and support. At the time of our inspection around 120 people were receiving a service, with a turnaround of about 200 people a month going through the service.
On the day of our inspection, there was 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.
Since our last inspection there has been an amalgamation of community short term reablement services in the city of Brighton and Hove into this one service.The service was also going through a significant period of review, where the provider and local stakeholders were looking at the service provision, what care and support was needed in the city, and how the service would best be provided in the future.
People and their relatives spoke well of the care and support provided. However, they also spoke of a lack of continuity of care staff providing their care calls. New care staff did not always proactively show their identification card (ID) to confirm with people they were representatives from the agency. This is an area that requires to improvement.
The needs and choices of people had been clearly documented in their care and support plans. Where people’s needs changed, people’s care and support plans were reviewed to ensure the person received the care and treatment they required. However, the detail in people’s care and support plan was variable. This is an area that requires to improvement.
People and their relatives told us that they or their relative felt safe with the staff that supported them. Detailed risk assessments were in place to ensure people were safe within their own home and when they received care and support.
Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.
There were enough care staff in the service to provide peoples care calls, who had been recruited through safe recruitment procedures.
People told us they were involved in the planning and review of their care. Where people were unable to do this, senior staff told us they would liaise with health and social care professionals to consider the person’s capacity under the Mental Capacity Act 2005. Care staff had a good understanding of the need for people to consent to their care and treatment.
Care staff received an induction, basic training and additional specialist training in areas such as supporting people as part of the reablement service provided. Care staff had supervision in one to one meetings and staff meetings, in order for them to discuss their role and share any information or concerns.
People and their relatives told us they were supported by kind and caring staff. Comments received included, “You can talk to them and have a laugh with them,” ”It’s a bit like having a friendly mother around to help you,” and “They make my day and make me laugh.”
People told us they always got their care visit, that they were happy with the care and the care staff that supported them. People were consulted with about the care provided. They knew how to raise concerns or complaints if they needed to.
The registered manager,along with senior staff provided good leadership and support to the care staff. They were involved in day to day monitoring of the standards of care and support that were provided to people. One staff member told us, “It’s a brilliant company. We get the training, we are listened to. We are a team and well supported.”
Systems were in place to audit and quality assure the care provided. People were able to give their feedback or make suggestions on how to improve the service, through the reviews of their care. There was evidence as to how any feedback was acted upon and improvements made to the service provided.