Chiltern Health Division

Updated 10 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors and 4 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. The general manager had submitted an application to CQC to become a second registered manager in the service.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a domiciliary care agency and we needed to be sure that the provider or general manager would be in the office to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 12 people and 21 relatives about their experience of the care and support provided. We visited 2 of those people in their own homes. We spoke with the general manager who facilitated the inspection. We spoke with and/or received email feedback from 17 staff which included the client liaison manager, client liaison assistant, head team leader, medicine auditor, team leaders, senior care staff and care staff. We spoke with 2 professionals who worked with the service.

We looked at aspects of care records for 13 people and some medication records. We reviewed a range of documentation relating to the management of the service including training records, meeting notes and quality assurance audits.

Updated 10 February 2023

About the service

Chiltern Health Division is a domiciliary care agency providing personal care and support to people in their own homes. 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. At the time of our inspection there were 170 adults and 3 children/young people who received packages of support which included personal care.

People’s experience of using this service and what we found

Some areas of people's care records required strengthening to ensure risk assessments were in place and personalised for known risks, and care plans reviewed regularly and updated after any changes occurred.

Some notifications had not been submitted to CQC as required by law, and this was rectified during the inspection.

Quality assurance audits took place in most key areas of the service, and the provider introduced additional checks during the inspection to strengthen oversight further.

Staff understood safeguarding procedures. Safe recruitment practices were followed to ensure staff were suitable for their roles.

People normally received care from a consistent group of staff who arrived within a window of time and stayed for the duration of the call. Calls were monitored on a live system and regularly audited to identify and rectify any arising issues. People and their relatives were usually informed if carers were running late.

People were supported safely with their medicines and good infection control practices were in place.

Staff reported and followed up on accidents and incidents promptly. Lessons were learned when things went wrong, and learning was shared with the staff team to reduce the risk of the same thing happening again.

The provider and management team were proactive in their approach to ensuring people received high quality care. They were supportive of the inspection process and keen to drive continuous improvements to the service. A high majority of people were confident any arising problems or issues would be resolved in a timely manner.

Very positive feedback was received from professionals who worked with the service. The staff team felt supported and gave positive feedback about teamwork and working for Chiltern Health Division.

Staff understood and followed the principles of the Mental Capacity Act and sought consent, offered choice and supported people make decisions about their care.

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 good (published 7 August 2021.) We made a recommendation for the provider to ensure an accurate information system was developed to provide up to the minute information to ensure a good outcome for people and staff. At this inspection we found improvements had been made in this area.

Why we inspected

The inspection was prompted in part due to concerns received about call times and some aspects of care. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained 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 Chiltern Health Division on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.