Blakehill Healthcare Bristol

Blakehill Healthcare (hereafter referred to as Blakehill) is a domiciliary care agency providing personal care to people in their own homes. The service provides support to older people and people with physical impairments. At the time of our inspection there were 32 people using the service. 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

People were positive about their experiences of using the service, they told us they felt safe and got on well with staff. Comments included, “They are very kind and caring”, and “I feel very safe with my carers they are very good, they are so kind”.

At our last inspection we found a breach of regulation in relation to staff recruitment. At this inspection we found improvements had been made. There was clear evidence of the checks and assessments that had been completed in order to make a robust decision about employment. Some people had support with their medicines, and we saw there was a system in place to document the medicines people received and when they had been administered. Records weren’t always clear in relation to topical cream administration and we have made a recommendation to address this.

Staff felt supported and able to approach senior staff if they had any concerns. Staff had formal supervision sessions when they were able to discuss their support and development needs. They were also subject to spot checks, whereby a senior member of staff attended a care call unannounced. If concerns were ever raised about a member of staff, we saw that these were investigated, and steps taken to support them; for example, by providing extra training if needed.

The service was rated as requires improvement under well led at our last inspection. This improved to good at this inspection. We saw the provider had taken account of our previous findings and taken steps to address them. There was a person centred culture where people and their relatives were a part of care planning and their views and opinions taken in to consideration.

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 25 February 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and recruitment. A decision was made for us to inspect and examine those risks. 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 changed from requires improvement to good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Blakehill on our website at www.cqc.org.uk.

Blakehill is a domiciliary care service providing personal care to 29 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

We found concerns in relation to recruitment. Full information about staff was not always documented at the recruitment stage to enable safe decisions to be made. It is a requirement of legislation to collect a full employment history for staff, but this was not complete in the sample of recruitment files we checked. This combined with staff including very limited information in their application forms made it very difficult to assess staff’s suitability for the role.

People were positive about their experiences of using the service. They told us they felt safe with staff and that if they had concerns, they could raise them with the manager. People told us that usually if staff were running late, someone from the office would let them know this was the case. The manager was in the process of carrying out care reviews with people so that they had opportunity to be involved in planning their care.

People told us staff used appropriate PPE and disposed of it safely. Spot checks were carried out to ensure staff were carrying out their roles safely. The service worked with the local authority to investigate concerns when necessary.

There were systems in place to monitor the safety and quality of the service provided. This included computer systems that helped the manager monitor that care calls were taking place as planned. The system alerted the manager at any time when staff had not logged in to a call, in order for this to be checked.

There was a plan for the service to move in to providing care in supported living services and senior staff had been recruited with a view to supporting this process.

Rating at last inspection

The last rating for this service was Good (published 31 August 2018). The rating has changed to requires improvement as a result of concerns found at this inspection.

Why we inspected

The inspection was prompted in part due to concerns received as part of the safeguarding processes and whistleblowing. These concerns related to staffing levels and recruitment, infection control procedures and leadership of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe section of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service predominantly provides care to people at the end of their lives. At the time of our inspection, 12 people were receiving care.

There was a registered manager in place, although they were due to go on long term planned leave at the time of our inspection. Plans were in place to cover the registered manager’s absence.

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 very positive about the care they received from Blakehill. Comments included, “They look after me really, really well”, “wouldn’t change them for the world” and “very happy with them”. It was evident that strong positive relationships had been built between people and the staff that supported them.

People’s care was reviewed regularly to ensure that it continued to meet their needs. Nobody we spoke with had cause to complain but told us they would feel able to if necessary.

People received a safe service. There were systems in place to monitor that calls were taking place as planned. People confirmed that staff always attended as expected. There were occasional difficulties with staff running late but people told us they were always informed if this was the case. We discussed with the registered manager how some more detail in their care documents around medicines would be helpful to further reduce the risks of errors occurring. However overall systems for administering medicines were safe.

Staff were all positive about their training and support and received regular supervision. This helped the registered manager monitor their performance and development needs. Staff received specific training in end of life care to enable them meet the needs of people they supported.

The service was well-led. Staff felt well supported and people receiving care were all positive about the service received. There were systems in place to monitor that the quality and safety of the service.