Background to this inspection
Updated
4 July 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection was carried out by one inspector and one assistant inspector.
Service and service type: Black Country Care - Supported Living and Home Care provides care and support to people living with learning disabilities in four separate 'supported living' settings so that they can live as independently as possible.
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: We gave the service 48 hours’ notice of the inspection visit because it is small, and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The provider was registered to deliver the regulated activity of personal care from 134 High Street, Rowley Regis B65 0EE. At the providers request, we visited an office location at 145, High Street, B65 0EE on 29 May 2019. Prior to the inspection the address change has been updated on the providers registration certificate.
What we did: When planning our inspection, we looked at the information we held about the service. This included notifications received from the provider about deaths, safeguarding alerts and serious injuries, which they are required to send us by law. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also asked stakeholders, such as the local authority safeguarding team and commissioners, for their views of the service.
During our inspection visit to the office, we met and spoke with four people who used the service who had come into the office to speak with us about their experience of care and support. In addition, we spoke with the Head of Care, the registered manager and four support workers. Following our inspection, we spoke with three support workers and five relatives of people who used the service. We used this information to form part of our judgements.
During our inspection visit to the office, we looked at five people's care records to see how their care and treatment was planned and delivered. Other records we looked at included four recruitment files to check suitable staff members were recruited and received appropriate training. We also sampled records relating to the provider’s oversight of the quality and safety of the service.
Details are in the 'Key Questions' below.
Updated
4 July 2019
About the service: Black Country Care - Supported Living and Home Care provides care and support to people living in a 'supported living' settings, so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support. At the time of our inspection they were supporting 17 people who have a learning disability who received the regulated activity of personal care.
Enforcement: At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.
People’s experience of using this service:
People were not always kept safe because risks were not always assessed, monitored or mitigated. We received mixed views on staffing levels. People’s medicines were not consistently managed well. Accidents and incidents were not being consistently investigated and followed up. Where lessons could be learned to improve the service and make the care people received safer; these were not always identified and addressed. Staff described how they would keep people protected from potential harm and knew how to report allegations of poor practice
People received care and support from staff who had not always completed key and specialist training to meet people’s individual needs. People told us that staff sought their permission before providing care and support. However, we identified that the registered provider had not consistently understood their obligations under the Mental Capacity Act (2005). People told us they enjoyed their meals and they chose what they preferred. People were supported to meet their health care needs, when necessary.
People were supported by kind and caring staff that knew them well. Staff protected people's privacy and dignity when supporting people. People were supported to be as independent as possible.
People’s care plans were person centred and staff told us they worked hard to ensure people were supported as individuals. People and their relatives knew who to contact if they had any complaints.
The provider had some systems in place to enable them to assess and monitor the quality of the service provided, but these systems were not being used effectively to manage all aspects of the service. The quality monitoring and assurance processes were not effective in ensuring that the risks to people's health and safety were appropriately assessed, monitored and mitigated.
Rating at last inspection: The service was rated Good overall. Our last report was published on 22 October 2016.
Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk