Wigan Link

Updated 4 July 2019

The Inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was completed by one adult social care inspector from the Care Quality Commission. (CQC)

Service and Service type:

Wigan Link provides personal care to people living in their own homes. At the time of this inspection there were approximately 30 people receiving a regulated activity.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity took place on 5 and 15 February 2019. We visited the office location on these days to see the manager and office staff; and to review care records and policies and procedures. We completed telephone calls with relatives and staff on 18 February 2019.

What we did

Before the inspection:

Prior to the inspection we reviewed all of the information we held about the service in the form of notifications, previous inspection reports, expected/unexpected deaths and safeguarding incidents. We contacted Wigan quality assurance team before our inspection to establish if they had any information to share with us. This would indicate if there were any particular areas to focus on during the inspection.

During the inspection:

During the inspection we spoke with a wide range of people and viewed certain records in order to help inform our inspection judgements. This included the nominated individual, operations manager, five people who were supported by the service, the relatives of five people and four staff. We visited three people in their own homes and observed two people visiting the office.

Records looked at included care plans, daily records in people's homes, three staff personnel files, five Medication Administration Records (MAR), training records and quality assurance documentation. This helped inform our inspection judgements.

Updated 4 July 2019

About the service:

Wigan Link is a domiciliary care service, providing personal care to people living in their own home including a number of supported living settings. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of inspection there were approximately 30 people receiving a regulated activity. At the last inspection we rated the service as Outstanding, however, we have not been able to rate the service as Outstanding this time because there is no registered manager in post and an application to register a new registered manager has not been made.

People's experience of using the service:

The registered provider continued to provide exceptionally person centred care and support which people told us had significantly improved their quality of life. This included supporting people to develop their confidence and skills in ways which meant they were more empowered and in control of their lives and went beyond the expectations of their families and other professionals.

Exceptionally detailed assessments of people's needs had allowed for their care and support to be highly effective. Staff were knowledgeable about the needs and wishes of the person they supported. Staff were highly skilled and competent. Input from families and a broad range of involved professionals further contributed to the effectiveness of the care and support provided.

People were involved in choosing their staff and were consulted about who supported them. The service carefully matched staff to people receiving care and support.

Risk management policies were robust and supported people to manage the risks in their daily lives. Best practice guidance in relation to positive risk taking was an embedded practice and promoted the rights of an individual to make their own decisions with the support they needed. This had increased people's decision making opportunities and expectations.

The service promoted optimum health and wellbeing, some people had achieved very positive outcomes, including; significant weight loss, improved mobility and reduction in the frequency and severity of incidents of distress.

The service was exceptionally caring. Respect for people was a key value and was reflected throughout the service. Without exception, everyone we spoke with praised the caring and kind nature of their staff and the management team. People's communication needs had been identified and strategies developed to support people to be as involved as possible in decisions about their care and support. This had led to exceptional outcomes for some people who had been supported to communicate their feelings and had developed ways of responding which reduced some of the risks of harm.

Wigan Link had a fully embedded person-centred culture which contributed to the very high-quality care and support provided. People's expectations, and their families, were consistently exceeded.

People received exceptionally person-centred care which reflected their needs and preferences. Carefully matched staff contributed to the responsiveness of the support provided. Regular reviews of people's needs and preferences helped maintain focus on what was most important to the person. A diverse range of activities were designed around people's wishes and preferences, staff went to exceptional lengths to improve the quality of people's lives by supporting them to achieve their goals.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The service continued to embed these key principles within the service to empower people to live the life they chose. People we visited were clearly in control of their lives and were living the kind of life they wanted.

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 the time of inspection there was no registered manager in post. We discussed this with the nominated individual. They explained the service was being managed by the operations manager who intended to register with CQC.

The service had maintained and improved their own high standards. In part, this had been achieved by being open to continuous learning and development, working in close partnership with stakeholders and sharing knowledge with others.

Rating at last inspection: At the last inspection we rated the service as Outstanding 25 January 2016. At this inspection we have rated the service as Good overall, this is because there was no registered manager in post.

Why we inspected:

This was a planned comprehensive inspection.

Follow up:

The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.