About the service:

Team Brain Injury Support Limited is a domiciliary care agency. It provides personal care to people who are living with a brain injury, in their own homes. A service was being provided for thirty people at the time of the inspection.

People’s experience of using this service:

People received a service that was safe, effective, caring, responsive and well led.

The service had the characteristics of a good service in all areas.

Systems were in place to keep people safe.

People’s needs were met by suitable numbers of staff who worked in teams and knew them well.

People received support with their medicines as prescribed.

People were protected from the risk of infection because staff had received relevant training.

People were supported to prepare and cook food when appropriate.

People were treated with kindness and respect and staff spoke kindly about them.

People’s privacy and dignity was respected.

People received personalised care which was responsive to their individual needs.

People enjoyed a range of activities which they had chosen.

People had care plans in place which detailed how staff would support them and meet their needs.

People could access the complaints procedure and complaints were investigated appropriately.

People’s views were sought and they were included in the running of the service.

Rating at last inspection:

At our last inspection, (report published 29 October 2016) we rated the service as Good.

Why we inspected:

This was a planned comprehensive inspection.

Follow up:

We did not identify any concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated good. We will continue to monitor the service through the information we receive.

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

When we last inspected Team Brain Injury Support Limited on 29 July 2015 and 03 August 2015, we found the provider had not always deployed sufficient numbers of suitably qualified and experienced staff to meet people’s care needs and some records were inaccurate. During this inspection we found the provider had made improvements and was now meeting the regulations.

Team Brain Injury Support Limited is a domiciliary care agency providing personal care to people living in their own homes with complex needs following a brain trauma leading to cognitive impairment. At the time of inspection the service was supporting 18 people.

This inspection took place on 8 and 22 September 2016 and was unannounced.

There was a registered manager at the service. 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.

Family members felt their relatives were safe when they were supported by staff from the service. Staff had completed training with regard to safeguarding people and they gave us examples of the different types of abuse and what they would do if they suspected or witnessed abuse. People undertook a range of activities of their choice with the support of staff. Risk assessments were undertaken to identify and minimise risks to people’s health and wellbeing whilst taking part in activities. People’s needs were met by enough staff who worked in teams to ensure shifts were covered. The provider sought references and completed pre-employment checks before new staff could start work. People received support from staff to take their medicines as prescribed.

People were supported by staff who were trained and competent. Staff completed appropriate training and could access bespoke training. Staff were supported in their work through supervision, spot checks and appraisal. Staff had training in and understood legislation designed to protect people’s rights. People were supported to eat and drink in ways which met their needs. Staff supported people to visit the GP and the dentist when appropriate.

Positive caring relationships were developed with people using the service. People were encouraged to express their views and be actively involved in making decisions about their care and support. People’s privacy and dignity were respected and promoted by staff who understood how to support people with their personal care.

People received personalised care and support which was responsive to their needs. Initially, people’s needs were assessed and this formed the basis of their care plan. People’s care plans were detailed and showed people’s needs, wishes and preferences and informed staff how people wished to be supported. The provider had a complaints procedure in place and people and/or their relatives knew how to complain if they were not happy with the service provided. Complaints were investigated and responded to as well as changes made to improve the service.

The registered manager promoted a positive culture which was person-centred, open, inclusive and empowering. The registered manager had systems to monitor the quality of the service provided which included auditing the completion of records and following up issues identified. The provider sought the views of people using the service, their friends and family, as appropriate, through a system of spot checks, regular visits and an annual questionnaire which sought people’s views about the specific staff who supported them. Action was taken, as necessary to improve the experience of people receiving care and support.

Team Brain Injury Support Limited is a domiciliary care agency providing personal care for a range of people living in their own homes. These included people across a broad age range, including children, with complex needs following a brain trauma leading to cognitive impairment. At the time of our inspection there were 27 people using the service receiving a regulatory activity.

There was a manager in place at the service who had only recently taken up their post and was in the process of becoming registered. 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.

The inspection was unannounced and was carried out on 29 July 2015 and 03 August 2015.

People using the service and their relatives told us they felt safe. However, there were not always enough staff available to meet people’s needs. In addition, records were not always accurate and fit for purpose.

People and their relatives gave a mixed response to how the provider responded to their complaints. We have recommended that the provider seeks advice and guidance on adopting the latest best practice guidance in respect of responding to complaints by people using the service or those acting on their behalf.

Care plans were personalised and reflected people’s individual needs. Staff used the information contained in people’s care plans to ensure they were aware of their needs and how to support them.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided enough information to allow staff to protect people whilst promoting their independence.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain their family relationships.

People were supported by staff who had received the appropriate training, professional development and supervision to enable them to meet their individual needs. The manager had established a safe and effective recruitment process

Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

There were suitable systems in place to ensure the safe management and administration of medicines across the service. All medicines were administered by staff who had received appropriate training. Healthcare professionals, such as GPs and district nurses were involved in people’s care where necessary.

People and when appropriate their representatives had been involved in the planning and review of their care. People were supported to have enough to eat and drink by staff who had received the appropriate training, professional development and supervision to enable them to meet people’s individual needs.

The provider sought feedback from people using the service and their relatives in respect of the quality of care provided.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.