Boyce Care is a domiciliary care service which provides personal care to people with a learning disability such as Asperger’s or autism, or a physical disability. At the time of our inspection 17 people received personal care support from the agency. Most people receiving care lived in supported living accommodation.The inspection took place on 10 November 2016 and was announced.
There was a registered manager in post at the time of 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 and associated Regulations about how the service is run. The registered manager (who was also the provider) was not present during our inspection. Instead we were assisted by the manager.
Risks to people were identified and action taken to reduce the risk of harm. Accidents and incidents were recorded to look for trends.
Recruitment processes carried out were not always in line with the agency’s policy. Medicines systems did not always follow the agency’s policy or best practice. The manager acted on these shortfalls following our inspection.
The manager was not always aware of their responsibility in relation to notifying CQC of safeguarding incidents. However staff were knowledgeable on safeguarding and the signs to look out for, together with how they should report any concerns.
The manager told us there was on-going recruitment to the agency. Although people told us that they never experienced a missed call, staff said at times arrangements to cover people’s calls were disorganised as there were insufficient staff available. We noted from staff rotas that some staff regularly worked for several days without a break.
Staff were unaware of the principals of the Mental Capacity Act (2005). Mental capacity assessments had not always been carried out for people and where decisions had been made there was no evidence of best interest discussions. Staff did not have a good understanding of the Mental Capacity Act.
Staff received training to support them in their role however we found some essential training, such as first aid was overdue for some staff. Immediately following the inspection the manager was able to demonstrate to us that staff had been booked onto the relevant refresher courses.
People were supported to eat a healthy and varied diet. People attended a cooking club held at the agency’s office which enabled them to learn basic cooking skills. Where people had specific health needs these were recognised by staff and appropriate health care professionals were involved in their care.
People told us they were cared for by staff who were kind. Observations during our inspection told us that staff had developed good, close relationships with people. Staff displayed compassion when people needed reassurance and respected people’s individual wishes and choices. People had access to a wide range of individualised activities which responded to their interests, such as attending college, a cinema club or a music session.
Support plans for people were written in a person-centred way and included detailed information about people and guidance for staff where needed.
Should people wish to complain information was available to them on how to do so. People and their relatives were provided with the opportunity to give their feedback on the service. Committees and forums had been established so people could make suggested improvements and suggestions made were listened to and acted upon.
Staff were involved in the running of the agency as meetings were held. Staff told us they felt supported by the management team and could approach and talk to them if they had any concerns.
Regular quality assurance audits were carried out to monitor the quality of the service provided and action taken where shortfalls were identified. In the event of an emergency there was a contingency plan in place to help ensure that people who required it, continued to receive care.
During our inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made some recommendations to the provider. You can see what action we told the provider to take at the back of the full version of the report.