About the service:

Blue Tree Care Limited provides personal care within people’s homes and when they access the community.

People’s experience of using this service:

At the last inspection we found that Blue Tree Care Limited required improvement and we identified breaches of three of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to the safe management of medicines, lack of detail in care plans and lack of an auditing system to monitor the quality of the service.

At this inspection we found that the service had improved and was meeting all the required regulations.

Medicines were managed safely in line with recent and best practice.

Care plans were person-centred and contained pertinent information.

A number of quality audits were in place to ensure and improve the quality of care.

Relatives and staff were complimentary of the service. People, relatives and staff were asked for feedback on their experience of the service through surveys and telephone calls.

Staff were professional and competent. Staff felt supported, listened to and able to contribute to the running of the service.

Relatives said the service was safe. Staff demonstrated a good awareness of each person's safety and how to minimise risks for them.

Staffing levels were good. Relatives told us that people received consistent support from the same carers.

Staff were recruited safely and the appropriate pre-employment checks were in place.

Staff were given an induction and training suitable to their job role. Staff were assessed for their competency which helped to ensure they were safe to work with people.

Staff told us they were given time to get to know people as part of their induction. Relatives felt this was good practice as staff got to know the people they were supporting on a personal level.

People’s calls were on time or staff called if they were going to be late.

The service worked in line with the Mental Capacity Act 2005 and staff had a clear understanding of how to support people with fluctuating capacity and giving support with decision making.

Feedback from relatives and staff was that the service was well-led. They told us the management team was always available to speak with.

People told us they would feel confident to raise any complaints they might have.

Rating at last inspection: The service was last rated as requires improvement (12 April 2018)

Why we inspected:

This was a planned inspection based on the last inspection rating.

Follow up:

Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for services rated good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Blue Tree Care Limited is a domiciliary care agency which provides care and support to people living in their own homes and flats in the community. The care agency offers a variety of services, including assistance with personal care, support with medicines and domestic tasks. Not everyone using Blue Tree Care Limited receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

We carried out this inspection on 26 February 2018. The inspection was announced to ensure that the registered manager or other responsible person was available to assist with our inspection. Blue Tree Care is a relatively new service and this was its first CQC inspection. At the time of our inspection, the service was providing support to eight people, the majority of whom lived in the Glodwick, Werneth, Clarkesfield and Coppice areas of Oldham. The service was run from an office in the home of the registered manager.

The service had a registered manager, who had registered with the CQC in February 2017. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At this inspection we found breaches of three of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to the safe management of medicines, lack of detail in care plans and lack of an auditing system to monitor the quality of the service. You can see what action we have told the provider to take at the back of the full version of the report.

People we spoke with were complimentary about the care their relatives received from Blue Tree Care. They told us their relatives were safe, and that the staff were caring and treated their relatives with respect.

Recruitment checks had been carried out to ensure staff were suitable to work with vulnerable people. Staff had been trained to carry out their roles and were regularly supervised. The registered manager carried out weekly ‘spot checks’ where they observed care being provided. This ensured the standard of care was monitored and people had an opportunity to comment about the support that was given to their relatives.

There were sufficient staff to provide care to the people being supported by the service. Work rotas were arranged so that people were generally supported by a regular carer who was familiar with their needs. Staff used the appropriate equipment, such as disposable aprons and gloves when carrying out personal care tasks.

We found a lack of systems in place for the safe administration of medicines. There were no specific care plans to guide staff on the way to support people with their medicines. Documentation used to record when medicines had been given was not in line with current guidelines on best practice. Care plans did not contain sufficient detail and some were not accurate.

There were systems in place to record accidents, incidents and complaints. People told us they were happy with the way the service communicated with them. The service had engaged with the local community through its contact with local mosques.

There was a lack of formal systems for monitoring the quality of the service, although the registered manager regularly sought verbal feedback from people who used the service and their families about the standard of care they received.