Bosun Care Limited

Bosun Care Ltd is registered to deliver homecare and supported living and provides the regulated activity of personal care to people living in their own homes to adults who live with mental health difficulties, learning disabilities and autism. CQC only inspects the service being received by people provided with 'personal care’; such as help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection there were 4 people using the service who were receiving personal care.

The assessment was carried out due to emerging risks about the service and in part by a notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident.

The service had been previously inspected and rated good at the provider’s previous registered location. This was the first assessment of this service under the provider’s new registered location. Therefore, we assessed all quality statements across the safe, effective, caring, responsive and well-led key questions under the provider’s new registered location. As a result of this assessment, we rated the service as requires improvement. We found 3 breaches of the legal regulations in relation to the management of people’s medicines, person centred care and the service’s governance systems including their record keeping.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right Support, Right Care, Right Culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

We found the service did not fully understand or apply the principles of the ‘Right Support, Right Care, Right Culture guidance, and the Real Tenancy Test, which is the guidance CQC follows to ensure that people in supported living arrangements have genuine human and tenancy rights.

We were not assured that people received person-centred care based on their choices and preferences. We found people had been supported to access the community and to attend a range of activities in line with their needs and preferences; however, it was not clear from people’s care records and the providers auditing systems that this had been a consistent approach in the support they received to live a meaningful life and in a home of their choice. Therefore, it was not clear how people had consistently been given real choices and control over their tenancy and how they wished to live their life.

Records relating to the planning and delivery of people’s care records were not always complete and detailed. The management of people’s medicines were not always explicitly clear, putting people at risk of receiving inappropriate care and medicines.

The provider’s oversight and records of staff training, recruitment, support and development needed to improve to demonstrate people were supported by qualified, competent staff which had been recruited safely.

People were supported by a team who knew them well. Staf spoke of people with kindness and compassion. There were regular opportunities for people and their relatives to provide feedback about their care and support.

The management team carried out regular site visits and undertook governance checks to help them monitor people’s support needs and well-being. Incidents were investigated and actions and learnings were carried out; however, we were not ensured there was a shared learning culture across the service and CQC had been notified of all relevant incidents.

The provider has been proactive since our assessment and addressed our feedback and implemented a service improvement plan. However, further time was needed for the provider to embed their governance strategies and action plan for the supported living service.

We have asked the provider for an action plan in response to the concerns found at this assessment.