Archived: Brevin Home Care

We found the following areas of good practice:

• The provider was able to assess urgent referrals quickly and non-urgent referrals within an acceptable time. There was rapid access to a doctor when required and where a deterioration in a client’s health was observed, staff responded appropriately.

• There were appropriate systems in place to manage medicines safely. There were effective handovers between nurses at the start and end of each shift. There was an effective handover between care teams when clients transferred into the care of the provider or out.

• The appointment of a registration and compliance consultant and introduction of file audit systems had led to improvements in the quality of care and treatment records from February 2016. All information needed to deliver care was stored securely and available to nursing staff when they needed it in an accessible format.

• The  providers registration and compliance consultant with nursing background, was developing further governance processes to improve the quality and safety of services. Clients knew how to complain if they were unhappy with the service provided. Complaints were centrally logged and details of the investigation, its outcome, actions take and feedback to the complainant were readily available. Incident reporting procedures were in place and staff demonstrated an awareness and understanding of these. Staff were open and transparent and fed back to clients the outcome of incident investigations and complaints.

• Nurses were matched to clients according to their skills and experience and a suitably skilled nurse provided care on each shift. Appropriate pre-employment checks were completed prior to nurses taking up their positions. Staff were required to complete a range of mandatory training, including safeguarding. Take up of mandatory training was high. Staff were trained in and had a good understanding of the MCA 2005. Staff reported experiencing job satisfaction and good morale within the service.

However, we also found the following issues that the service provider needs to improve:

• Staff did not undertake a risk assessment of every patient during initial assessment. For clients who had completed a home detoxification programme there were variations in the availability and quality of initial assessments. For one client an assessment addressing the risks to children living with them during a detoxification programme had not been completed. The provider had developed a standardised referral and assessment tool. However, this had not been completed for all clients and the quality of referral and assessment information varied between different independent doctors.

• Whilst staff had been able to access group supervisions in November 2015 and Febuary 2016, staff did not receive one to one clinical supervision. Nurses supplied by the agency were not required to complete mandatory or specialist training relating to substance misuse.

• Independent translation and interpretation services were not always used when providing care and treatment to clients for whom English was not their first language.