This first inspection of Best Support Care Ltd, a small domiciliary care agency, rated the service Requires Improvement overall, with safe and effective rated Requires Improvement due to gaps in care plan updates, risk mitigation guidance, PRN protocols, mandatory training and staff supervisions. Caring, responsive and well-led were rated Good, with kind staff, person-centred care and a responsive registered manager who acted swiftly on feedback.
Concerns (7)
moderateCare planning: “People's care plans were not regularly updated. As a result, some information was not accurate. For example, information about two people's mobility needs were not recorded correctly.”
moderateCare planning: “Risks to people's health and safety were identified, however the guidance for staff on how to mitigate them was not always provided.”
moderateMedication management: “Some people were prescribed pain relief medicines to be taken 'When Required' (PRN). However, there were no PRN protocols in place with clear guidance on when to administer the PRN medicines.”
moderateStaff training: “Staff had access to required training for their role, however not all staff completed all mandatory training modules.”
moderateSupervision / appraisal: “Staff had not receive formal supervisions or appraisals. This reduced their opportunities to develop, review their practice and focus on professional development.”
moderateGovernance: “Governance and quality assurances were not always effective. Systems did not always identify areas for improvement.”
minorRecord keeping: “Although the information in people's care plans were not always up to date, the staff knew people very well and understood their current needs.”
Strengths
· People received support from kind and caring staff who were respectful and promoted independence.
· There were enough staff to meet needs and people received their support visits on time.
· Safe recruitment procedures were used, including DBS checks and references.
· Staff followed safe infection prevention control practices and used PPE effectively.
· The provider worked collaboratively with other professionals such as district nurses and occupational therapists.
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementNot rated
safe: Using medicines safelyNot rated
safe: Staffing and recruitmentNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Learning lessons when things go wrongNot rated
safe: Preventing and controlling infectionNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staff; Working in partnership with othersNot rated