We carried out a review of the data available to us about BoJo Care Services Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about BoJo Care Services Ltd, you can give feedback on this service.
BoJo Care Services Ltd is a domiciliary care agency providing personal care to 8 people at the time of the inspection.
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
Areas of improvement were found in relation to the oversight of the service, with improved oversight of systems and processes. Risks to people's health and safety were assessed and regularly reviewed.
There were enough staff to meet people's needs and the provider was operating a continuous recruitment process to increase staffing levels further. Safe recruitment processes were followed. Staff received good levels of support, training, and supervision in order to be able to carry out their roles effectively. The provider valued the well-being of the staff team.
People and relatives were happy with the service and the care people received. A new staff rota system had been implemented since the last inspection and most people and relatives reported they received care from consistent staff who mostly arrived on time and stayed for the correct duration.
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.
Medicines were administered safely. People were well protected by infection prevention and control measures. Incidents were reviewed, lessons learned and improvements identified and shared. People were treated with respect. Care plans recorded how people were involved in their care. Their views and wishes were at the centre of their support.
Systems and oversight had improved to monitor the quality of the service people received. The registered manager was committed to providing a high-quality service to people with a strive to continuous improvement
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 22 February 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has improved to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for BoJo Care Services Ltd on our website at www.cqc.org.uk.
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.
BoJo Care Services Ltd is a domiciliary care agency providing personal care to nine people at the time of the inspection.
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
Not all internal policies and procedures, to guide staff in safe delivery of their work, had been reviewed and updated to accurately reflect the services provided.
People’s care records needed updating so clear guidance was available to direct staff in the care and support people wanted and needed. Information was to be added to the electronic devises held by staff making them more easily accessible.
Contemporaneous records were not maintained in respect of people’s medication support. We saw information had been amended, as errors had been found during an audit of the records.
The providers current rating was displayed on their website. However, this had not been done in a timely manner immediately following the last inspection.
Governance systems still need embedding to evidence their effectiveness as well as demonstrate clear oversight and scrutiny of the service, so that continuous improvement is made and sustained.
People and their relatives spoke positively about the service and staff. We were told communication was good and people had confidence and trust in the care staff.
Areas of improvement were found in relation to recruitment records and risk management. Relevant information and checks about the character and suitability of new staff had been sought prior to them commencing employment. Staff said there were sufficient numbers of staff available and they felt supported in their role.
Areas of risk were assessed and planned for. Observations and checks were also carried out on staff to make sure their practice was safe.
Suitable arrangements were in place for the management of people’s prescribed medicines and safeguarding procedures.
Systems and process to help minimise the risk of cross infection were in place. Staff had received additional training and personal protective equipment was readily available.
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 8 October 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection on-going improvement was needed and the provider was still in breach of regulations. This service has been rated inadequate or requires improvement for the last four consecutive inspections.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has stayed the same. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for BoJo Care Services Ltd on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified an on-going breach in relation to good governance by the provider.
Please see the action we have told the provider to take at the end of this report.
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.
BoJo Care Services Ltd is a domiciliary care agency providing personal care to 12 people at the time of the inspection.
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
The provider did not satisfy themselves that staff were of good character when conducting pre-employment checks. References were not always obtained from people’s previous employers and were not verified. References were obtained from the registered manager and other employees who worked for the provider which did not show impartiality. The provider had failed to improve the recruitment process and had not followed their own recruitment procedures.
Risks to people were not robustly assessed and guidance was not in place to safely support people. A person who was at risk of choking and who required support with moving and handling was not risk assessed.
The management of medicines had improved. We made a recommendation for the provider to use an eye drop MAR chart rather than a topical cream chart for the administration of eye drops.
Assessments of people’s needs required further work to ensure they were holistic and captured people’s full support needs. Staff received regular supervision. Supervision was sometimes completed by the registered manager for their own relative which did not show impartiality. Also, the supervision record did not include an agenda item in relation to the COVID-19 pandemic. We recommended this agenda item is added to allow staff the opportunity to ask questions or seek further guidance.
The provider has failed to respond to concerns fully from previous inspections and failed to ensure robust processes were in place to ensure people were supported safely. Audits to monitor and improve the service did not highlight our findings from the inspection.
Relatives told us they were happy with the service and staff said they were well supported.
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.
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 31 December 2019). At this inspection enough improvement had not been made and the provider was still in breach of regulations. This service has been rated inadequate or requires improvement for the last three consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has stayed the same.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for BoJo Care Services Ltd on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation safe care and treatment, good governance and fit and proper persons employed by the provider.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.
Bojo Care Services Ltd is a domiciliary care agency providing personal care to 11 people in their own homes at the time of inspection.
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
The governance of the service had not improved since our last inspection in relation to recruitment of staff. The provider and registered managers were not clear on the expectations of themselves under their registration with the Care Quality Commission. Audits to monitor and improve the service were in place and highlighted some concerns but not enough to mitigate the concerns we found with recruitment.
Staff were not always safely recruited and pre-employed checks were not satisfactory. The management of medicines was unsafe and people did not receive appropriate assessments for support with medicines. Some staff worked without appropriate supervision.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests with the management of medicines.
People received an assessment of their needs prior to using the service, however the assessment didn’t capture the support required for medicines management. People were supported to eat and drink by the staff team. Any concerns around people’s wellbeing was raised with professionals.
Care plans captured peoples likes, dislikes and preferences. Staff were aware of the strategies in place to support each person and could describe people’s plans of care. Information about the service was available to people in English and large print. Complaints were investigated and responded to.
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 13 December 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made / sustained to improve the safe recruitment of staff and the governance of the service and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated inadequate or requires improvement for the last three inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation safe care and treatment, good governance and fit and proper persons employed, at this inspection.
The administration of medicines was not safe. We could not be assured one person received their medicines at the correct intervals. Staff did not have competency checks of their ability to manage medicines safely.
Enough improvements had not been made to ensure the provider understood the requirements of the legislation for the safe recruitment of staff and followed safe recruitment processes. The provider had not been honest and transparent with is and had refused to send us information as required under the health and social care act
.
New staff members continued to be employed without the satisfactory pre-employment checks in place.
Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Since the last inspection we recognised that the provider had failed to display their current CQC rating on their website. This was a breach of regulation and we issued a fixed penalty fine. The provider accepted a fixed penalty and paid this in full.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The last inspection of this service was on 6 and 7 March 2018 where we found breaches in six regulations of the Health and Social Care Act 2008, including concerns that placed people at serious risk of harm. These were in relation to unsuitable care planning and risk assessments to support people, lack of training and supervision for staff, unsafe recruitment practices, not reporting allegations of abuse to the Care Quality Commission (CQC) and not complying with the Mental Capacity Act 2005. Following the inspection, we asked the service to take some immediate action and asked the provider to complete an action plan to address the issues we had found. After our last inspection, the provider agreed to a voluntary embargo on providing services to any new people while they addressed the issues we had raised.
At the last inspection, we rated the service overall, inadequate and the service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this time frame.
During this inspection the service demonstrated to us that improvements had been made and is no longer rated as inadequate overall, or in any key questions. Therefore, this service is now out of Special Measures.
The service is a domiciliary care agency. It provides personal care to people living in their own homes and flats in the community. It provides support to people with learning disabilities, physical disabilities, older people, dementia, sensory impairment, mental health and younger adults.
Not everyone using Bojo Care Services Limited 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.
At the time of the inspection, Bojo Care Services were supporting ten people with personal care.
A registered manager was in place. ‘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.’
Staff members were not always recruited safely and did not have the required checks in place to ensure they were suitable to work with vulnerable groups. This was a continued breach from the last inspection.
Risk assessments to support people safely had improved and identified the risks posed to people. Risk assessments gave guidance to staff to ensure the level of risk were reduced and keep people safe from harm.
People felt safe while being supported by Bojo Care Services Limited and staff were aware of their responsibilities to report any safeguarding concerns they had. Staff were confident the management of the service would act on any concerns they had and the registered manager was aware of their responsibility to report any allegations to CQC.
The provider worked in line with the Mental Capacity Act 2005. Improvements had been made to ensure people had their capacity assessed and any concerns about people’s understanding were reported to the local authority. People gave consent to be supported with care and support.
Staff received training suitable for their job role. Training was regular and was provided by an external provider or via eLearning. Staff told us the training was good and aided their knowledge.
Staff received an induction to their role. The induction formed part of the care certificate which is an agreed set of standards, care workers should work towards. Work books were completed by staff members but were not always marked to ensure the information recorded in them was correct. We recommended the work books are checked and marked at regular intervals to ensure staff have the correct knowledge.
People supported by the service received a pre-assessment of their needs to ensure the service could meet their needs. The pre-assessments were detailed and confirmed people’s health and social care needs, including assistance needed with mobility, communication and personal care.
We observed caring and dignified interactions between people and the staff team supporting them. We heard friendly conversations and people told us they felt staff were respectful to them.
People and relatives told us they felt staff were caring towards them.
Care plans had improved and were reflective of people’s needs. People and their relatives had been involved in their care planning and were involved in reviews to ensure the information remained up to date.
The service had received no complaints since the last inspection. People told us they knew who to contact if they felt they needed to make a complaint.
Audits to monitor and improve the service had somewhat improved but had not identified the gaps in the recruitment of staff.
Policies and procedures to assist in managing the service were in place but required reviewing to ensure they remain up to date.
Staff felt well supported by the management team.
At this inspection, we found seven breaches of the Health and Social Care Act 2008 in relation to person centred care, consent, safety, safeguarding, good governance, staffing and fit and proper persons employed. Following the inspection, we told the service to take some immediate action to address the issues we found.
You can see what action we have told the provider to take at the back of the full version of this report. We are currently considering our options in relation to enforcement and will update this section once any enforcement action has concluded. As a result of our concerns, the provider agreed a voluntary embargo of new care packages. This meant the provider would not be taking on any new packages of care until it was agreed with the Care Quality Commission (CQC) that the necessary improvements had been made.
Bojo Care Services Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. The service provides care to a range of people with different needs including older people, people living with dementia, learning disabilities, physical disabilities and mental health conditions. When we inspected the service, there were 27 people receiving domiciliary care. Calls to people’s properties ranged from 30 minutes to two hours per visit. Not everyone receives regulated activity; the Care Quality Commission (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.
This was BoJo Care Services Limited first comprehensive inspection since being registered with the Care Quality Commission.
Bojo Care Services Limited is owned and operated by the registered manager and the nominated individual.
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.’
People were not safe. There were no risk assessments in place to mitigate risk and support people with moving and handling. For example, there was no risk assessments devised for the care of pressure areas or for people who could be verbally or physically aggressive to others.
Care plans for people were not reviewed or involved people or their representatives. There was no evidence that care plans had been updated.
The service did not follow the principles of The Mental Capacity Act 2005. People did not have their capacity assessed as appropriate. The service did not have a mental capacity policy and was not working within the framework of the mental capacity act.
Prior to agreeing a care package. The service should assess people and the service to ensure that they can meet people’s needs. Pre assessments of people were incomplete and did not identify the full needs of people.
Medication was not safely managed. In addition there were no audits in place to monitor the safe administration of medication. There were inconsistencies in staff training in medication administration and medication records were not appropriately recorded. Staff members were not competently assessed to administer medication.
Staff were not supported by robust systems of training and monitoring. Training was not sufficient to enable staff members to carry out their role effectively.
There were no systems in place to assess, monitor and improve the service. There was a lack of scrutiny and oversight by the registered manager to ensure that people received safe care and treatment. The management team did not regularly review people's daily notes so they were unaware of changes to people's support or incidents that occurred and did not follow them up to ensure that appropriate action had been taken.
Recruitment procedures were not followed and new staff members were not always recruited safely.
One allegation of abuse that we are aware of had not been reported to the Care Quality Commission (CQC).
There was a complaints procedure in place and one complaint had been responded to appropriately
The overall rating for this service is “inadequate” and the service is therefore in “special measures”.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of their service, they will be inspected again within six months. The expectation is that the provider to have made significant improvements within this time frame.
If not enough improvement is made within this time frame so there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to being the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be continued to be kept under review.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service demonstrates improvements when we next inspect and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.