This announced inspection took place on 27 November 2018. We gave 24 hours' notice of our intention to visit the provider’s office to make sure people we needed to speak with were available. At the time of our inspection 68 people were receiving support from the service.Bespoke Care & Support Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults living in the Huddersfield area. Everyone using Bespoke Care & Support Services was in receipt of the regulated activity of 'personal care’; help with tasks related to personal hygiene and eating. Where relevant, we also take into account any wider social care provided.
Bespoke Care & Support Services was last inspected on 9 September 2017. At that time, it was rated requires improvement overall and was in breach of regulations in relation to staff's access to training and supervision and good governance. At this inspection, we found improvements had been made in these areas and the provider was no longer in breach of regulations.
On the day of our inspection a registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
The provider’s compliance with the Mental Capacity Act 2005 (MCA) was inconsistent. The registered manager had a good understanding of how to support people who required best interest decisions made on their behalf however the record keeping and staff’s understanding around this area required improvement. We recommended the provider researches and implements best practice guidance to ensure specific decisions made in people's best interest are appropriately recorded.
Staff had completed safeguarding adults training and knew how to keep people safe and report concerns. People's medicines were safely managed.
People told us they felt safe due to the support they received from staff. Staff had a good understanding of how to support people safely and knew what to do if they had concerns about
people's safety.
Staff were recruited safely. There were enough staff to provide people with the care and support they needed.
People and their relatives felt staff had appropriate skills and were competent. Staff had a good understanding of the people they supported and had access to ongoing training and supervision to support and improve their practice.
People told us they received a service that made a difference to their lives. Positive relationships had developed between people and staff. People and their relatives told us staff were consistently kind, caring and compassionate.
People were supported to have a balanced diet that met their individual dietary needs. They were supported to access healthcare services to maintain their health.
People were involved in their care. They were treated with respect and their dignity and privacy was maintained.
People’s needs in relation to the protected characteristics under the Equalities Act 2010, were considered in the planning of their care. People's communication needs were assessed
People told us they would feel comfortable to raise issues or concerns and that the management team and staff were friendly and approachable. The registered manager appropriately investigated complaints and incidents
People, their relatives and staff were complimentary about the leadership and management of the service. There were several systems in place to monitor the quality of care.