Blue Moon Care Limited

Updated 31 December 2019

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 Care Act 2014.

Inspection team

One inspector visited the service.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider/registered manager would be available to support the inspection.

What we did before the inspection

The provider was asked to complete a provider information return (PIR) prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with the person who used the service to ask them about their experience of the care provided and looked at their care records. We also spoke with two relatives.

We spoke with the registered manager, deputy manager and with three members of staff, which included two care staff and a maintenance person. We looked at systems for recruitment, supervision, appraisal and at staff training records. We also looked at quality monitoring records relating to the management of the service. We sought feedback from health and social care professionals who worked with staff. Unfortunately, we did not receive any responses.

Updated 31 December 2019

About the service

Blue Moon Care Limited is a bespoke domiciliary care agency in the Taunton area. It was established by a group of people and their carers to provide personal care to people living in their own home with Myalgic Encephalomyelitis/Encephalopathy (ME). ME is a serious disabling chronic neurological illness with a range of neurological symptoms. These include severe fatigue and muscle pain, sensitivity to light/noise and smells and with poor sleep patterns. People experience difficultly concentrating which sometimes affects speech and suffer regular relapses and remissions.

One person was currently receiving personal care from the agency and they provided wellbeing services to two other people. 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 received an exceptionally caring and compassionate service from a small team of staff, they knew well, who understood how their condition affected their daily lives. The service demonstrated a strong and visible person- centred culture which put people at the heart of everything they did. People praised staff who were excellent at promoting each person's dignity, wellbeing and independence, which improved their quality of life.

The registered manager promoted people’s human rights and inclusivity through equality and diversity training. People and staff advocated for improved services for disabled people through their ‘ME uncut’ project. They raised awareness of the condition through distributing information leaflets distributed to GP practices, schools and to the public and wrote an article for a local health journal. They also challenged and tackled disability discrimination wherever they experienced it, for example, in restaurants and public buildings.

People received an exceptionally personalised service because staff had an excellent understanding of their needs. Staff were committed to enabling people live fulfilling lives and supported them to achieve their goals. For example, they supported a person to obtain a master's degree in education and to work towards gaining employment. The registered manager used their educational expertise to teach a graduate how to amend the person’s study material to make it suitable for their use. This included breaking the information down into smaller sentences, and through the use of coloured text and larger fonts to make it more accessible to them.

People’s wellbeing was improved through an innovative wellbeing programme to support them with social interaction, mental stimulation and to learn new skills. For example, staff supported people to grow produce and make craftwork items, which they exhibited annually at the Taunton Flower show. Pictures of the 2019 show, an array of prizes and judges’ comments were proudly displayed in the agency’s office to celebrate their success.

People who used the service had a very close friendship and it was important to them to spend time together. When people were less well and unable to go out much, staff were increasingly using technology to support them to maintain social contact and prevent isolation. For example, using information technology (IT) to share messages of support, photographs, do arts and crafts and play games, watch films and other events virtually together.

The agency was exceptionally well led by the registered manager and their deputy who led by example. People and staff spoke about the high quality of care provided. Staff were motivated, enthusiastic and were proud to work for the agency. The provider promoted a positive culture that was person-centred, values based, open, inclusive and empowering. People, staff and management all worked together with input on priorities and decision making. For example, on training, developing policies and setting new goals.

Managers and staff worked tirelessly to give people with ME a voice through continually developing their ‘ME Uncut’ project and through contact with a member of a panel of experts developing clinical guidelines about ME for the National Institute for Health and Care Excellence (NICE). There was a strong emphasis on learning and continuous improvement. For example, the registered manager compiled a regular newsletter featuring articles of interest and relevance to people and staff. Following attendance at a training event about the introduction of General Data Protection Regulations (GDPR), they shared that knowledge by working with people and staff to create a local policy.

People received consistent support from well-trained care staff who knew them well. 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.

People said they felt safe as they were supported by a small team of staff they knew and trusted. Staff knew about the different types of abuse, ways to protect people and how to report concerns. Complaints and incidents were opportunities to learn and improve.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection – The last rating for this service was Outstanding (report published 18 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.