Bespoke Health & Social Care achieved an overall Good rating across all five key questions at this August 2019 inspection, demonstrating improvements in medicines management and safe recruitment since the previous inspection where Safe was rated Requires Improvement. Minor areas for development included reducing reliance on agency staff, addressing manager turnover, and ensuring all people with complex needs have end-of-life care plans in place.
Concerns (3)
moderate
Staffing levels
: “some people's package of care had to use agency staff due to the difficulties in recruitment. The provider had recognised this as a lesson learnt, in needing a new approach to staffing”
moderateGovernance: “The provider had recognised there was a high turnover of managers in some areas. They had completed exit interviews in the aim to establish any learning or areas of improvement.”
minorEnd-of-life care: “Some people had not considered an end of life plan. The provider recognised that given the complexed nature of people's care they should consider this area.”
Strengths
· Medicines management had improved since the last inspection, with monthly MAR reviews by the clinical lead and regular staff competency checks.
· Bespoke staffing teams provided consistent care, with people involved in the recruitment and 'meet and greet' of their own staff.
· Staff received comprehensive, individualised training including specialist areas such as PEG feeding, spinal care and septicaemia recognition.
· Care plans were detailed, regularly reviewed and included a wide range of communication methods tailored to individual needs.
· Strong partnerships with health and social care professionals supported timely, effective care outcomes.
Quality-Statement breakdown (22)
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitment; Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; staff induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies; supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive, person-centred, open and inclusive cultureGood
well-led: Duty of candour; transparency and notification of eventsGood
well-led: Continuous learning, audits and quality improvementGood
well-led: Engaging and involving people, the public and staffGood