Bionicare (Domiciliary Care Agency)

People were not always safe using the service. We found breaches of regulation in relation to safe care and treatment and staffing levels. The amount of support people needed from staff was not clear and staffing levels were not being monitored effectively to help make sure they were safe. Incidents and accidents were not always reviewed effectively to see if measures could be taken to improve people’s safety. People’s risk assessments and care plans were not always as clear or as detailed as they could be to guide staff to support people safely. Staff had a good understanding of safeguarding and how to report concerns however external reporting and review of incidents did not always occur. Staff were trained to support people and had a good understanding of their training and how to support people as best as they could. People’s home environments were kept safe and staff followed good infection prevention control (IPC) measures. People were supported safely with their medicines.

People were being supported to live in ‘supported living’ settings however some aspects of RSRCRC and living in a supported living setting were not always being considered or followed. It was sometimes unclear how people’s needs had been assessed under best practice guidance or how staff supported people to achieve outcomes related to their support needs. The staff team worked well together and with other professionals to help support people in the best way possible. Staff had a good understanding of the Mental Capacity Act (MCA) and supported people in line with the principles of this.

People were supported by kind and compassionate staff who knew them well as individuals. Staff supported people to make choices and be as independent as they chose to be. They enjoyed working at the service. People were very positive about the support they had from the staff team.

People’s care plans were not always as detailed as they could be in relation to how to support them with their specific needs or preferences. Staffing levels meant some aspects of people’s care plans would not be able to be followed effectively. Staff were not always monitoring and supporting people to achieve their desired outcomes. Staff knew people well and supported them in line with the Accessible information standard (AIS). People felt safe to speak up if they had a concern. People were very happy with their support and the relationships they had with the staff team. People were supported to speak about what they wanted to achieve in the future.

The service was not always well-led. We found a breach of regulation in relation to good governance at the service and notifiable incidents not being reported to the CQC in line with legislation. Audits were not being completed or were not always effective in monitoring the quality of the service, particularly in relation to safe staffing levels and how people were being supported to achieve their goals and aspirations. It was more difficult for the management and staff team to learn lessons and improve because of this. Incidents and accidents were also not always being effectively monitored to see where improvements could be made. The registered manager and management team were dedicated and passionate about the service and their job roles. They started to take immediate action to improve the service following on from this inspection. Staff enjoyed their jobs and felt well supported by the management team. People were happy using the service and were positive about how well led the service was.