Bespoke Home Care Ltd received a Good rating across all five key questions at its November 2016 inspection, having successfully remediated previous breaches of Regulations 17 and 19 identified in October 2015. The service demonstrated safe, person-centred care delivered by well-trained and well-supported staff within a robust governance and quality assurance framework.
Strengths
· People and relatives consistently reported feeling safe and well-cared for by kind, compassionate staff
· Robust safeguarding procedures in place with all staff trained in adult safeguarding within the last year
· Previous breaches of Regulation 17 (governance) and Regulation 19 (recruitment) fully remediated and sustained
· Electronic monitoring system used to verify staff arrived on time and stayed for the allocated call duration
· Detailed, person-centred care plans reflecting individual preferences, histories and needs
Quality-Statement breakdown (19)
safe: Safe recruitment practices including DBS checks, character references and conduct references from previous care employersGood
safe: Safeguarding awareness and reporting procedures understood by all staffGood
safe: Risk assessments in place and up to date; individual and environmental risks identified and managedGood
Bespoke Home Care Ltd was rated Requires Improvement overall following an October 2015 inspection, with two regulatory breaches identified: failure to ensure robust staff recruitment records (Regulation 19) and absence of effective quality assurance systems including MAR chart auditing and CQC notifications (Regulation 17). The service performed well in caring, effective and responsive domains, with staff praised by people and relatives, personalised care plans in place, and appropriate staffing levels maintained.
Concerns (7)
criticalRecord keeping: “All of the MAR charts we looked at for the last three months contained gaps where there was no indication of whether the medicines had been administered, refused or omitted.”
criticalGovernance: “The lack of effective quality monitoring of the service is a breach of Regulation 17 HSCA 2008 (Regulated Activities) Regulations 2014.”
criticalSafeguarding: “The registered manager and provider had failed to fulfil their legal responsibilities to notify the CQC of incidents where they suspected abuse may have taken place.”
criticalStaff competency: “The provider had not always obtained all the information they are required to hold about staff before they were deployed to work at the service. This is a breach of Regulation 19.”
moderateMedication management: “The absence of a robust quality assurance framework meant the provider had not identified and taken corrective action to address errors in the MAR charts.”
moderateSupervision / appraisal: “They recorded supervision and spot checks in staff member's personnel files but they did not have an overview of this information.”
moderateIncident learning: “Whilst complaints had been addressed by the provider on an individual basis, they had not all been recorded within the complaints log.”
Strengths
· People felt safe and were complimentary about staff, describing them as kind, patient, caring and genuine.
· Staffing levels were sufficient and appropriate action was taken to avoid missed or late calls.
· Staff received regular training including the Care Certificate and specialist training as needed.
· Care plans were personalised and regularly reviewed, reflecting individual preferences and changing needs.
· Staff demonstrated good understanding of dignity, privacy, independence and Mental Capacity Act principles.
Bespoke Home Care Ltd received a Good rating across all five key questions at its June 2019 inspection, with 38 people supported in their own homes. The service demonstrated safe, person-centred care with strong leadership, robust quality assurance, and consistently positive feedback from people and staff.
Strengths
· People felt safe, comfortable with staff, and reported no concerns around safety or dignity in their own homes.
· Staff demonstrated good safeguarding awareness and could identify types of abuse and appropriate reporting procedures.
· Medicines were managed safely with detailed risk assessments, MAR audits, and trained staff.
· Detailed, up-to-date risk assessments guided staff in hazard reduction; 24-hour on-call support was in place.
· Accidents and incidents were recorded with follow-up actions and trend analysis to prevent recurrence.
caring: Promoting independence and choiceGood
responsive: Person-centred care planningGood
responsive: Complaints handlingGood
well-led: Quality assurance and internal auditsRequires improvement