This announced inspection took place on the 30 and 31 May and 01 June 2018. The provider was given 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and support to people living in their own homes and we wanted to make sure staff would be available to talk to us about the service.

Birmingham Business Associate is a domiciliary care agency registered to provider person care to people living in their own homes. The service currently provides care and support to 25 people ranging in age, gender, ethnicity and disability.

There was a registered manager in post. 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 our last inspection on 08 and 09 May 2017 we found that the provider’s recruitment and quality monitoring systems and processes were not always robust and required improvements.

The provider had made improvements to their recruitment processes to ensure they employed suitable staff. Systems had been put in place to audit medication administration records (MARs) and log sheets. However, these audits had not been analysed to identify issues and trends to reduce future reoccurrence.

People were safe because staff had the skills and knowledge to meet their needs. Staff had a good knowledge and understanding of how to spot signs of abuse and where to report concerns to both internally and externally. People had the appropriate risk assessments in place to ensure risks to people were minimised. People were supported to take their medicines as required.

People and their relatives were involved in both initial assessments and reviews of their care. People were supported by kind and caring staff who knew their needs well. People were given choice and control over their care and staff supported them in the least restrictive way, promoting independence as much as possible. People had access to health care professionals when required.

People and their relatives knew how to complain and raise concerns. Complaints had been investigated and dealt with in an open and honest way and people and relatives were happy with the outcome. Feedback was sought from people and relatives via a quality questionnaire and audits were in place. However, the provider had not used the information from feedback, audits, complaints and incidents to identify trends and reduce the chance of reoccurrence.

This announced inspection took place over two days on 08 and 09 May 2017. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and support to people living in their own homes and we wanted to make sure staff would be available to talk to us about the service. This was the provider’s first inspection since relocating the office.

Birmingham Business Associates is a domiciliary care agency registered to provide personal and nursing care to people living in their own homes. The service currently provides care and support for 43 people, ranging in age, gender, ethnicity and disability.

There was a registered manager in post. 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 provider had recruitment processes in place however they were not always robustly applied and required some improvement. The provider had quality assurance systems in place to monitor the care and support people received. However, systems were not consistently effective in identifying and resolving issues on recording when medicines were to be administered.

People were kept safe because staff had a good knowledge of current safeguarding practices and how to apply these when supporting people. People received safe care because risks had been identified and were managed to minimise the risk of harm to people Sufficient numbers of staff were available to ensure people received support as they wanted. People were supported to receive their medicine as prescribed.

People were assisted by suitably trained staff that had the knowledge and skills they needed to do their job effectively. Most people felt staff had a good knowledge of their care and support needs.

People were supported to have maximum choice and control of their lives as much as was practicable and staff supported them in the least restrictive way possible; the provider’s policies and systems supported this practice. Health care professionals were involved in supporting people to maintain their health and wellbeing.

People were supported by caring and kind staff who demonstrated a positive regard for the people they were supporting. People had been encouraged to be as independent as possible in all aspects of their lives. Care was planned and reviewed with each person and, where appropriate, their relatives, to ensure the care provided continued to meet people’s needs.

People and their relatives were aware of how to raise concerns or make complaints and were generally happy with how the service was managed. Feedback was sought from the people who used the service and their relatives.