Headway Shropshire

Updated 24 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

At the time of the inspection Headway Shropshire did not have a manager registered with the Care Quality Commission. However, they had recently appointed a manager who had started their role and was in the process of applying to become a registered manager. This means they will, along with the provider, be legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours' notice of the inspection visit because it is a domiciliary care provider and the provider is often out of the office supporting staff or providing care. We needed to be sure they would be in.

Inspection site visit activity started on 17 June 2021 and ended on 25 June 2021. We visited the office location on 18 June 2021 and again on the 25 June 2021 to see the provider and staff; and to review care records, policies and procedures.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We asked the local authority and Healthwatch for any information they had which would aid our inspection. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and six relatives about their experience of the care provided. In total we spoke with nine staff members including five carers, a care co-ordinator the facilities manager, newly appointed manager and the nominated individual (chief executive officer). We reviewed a range of records. This included four people's care plans and records of medicines administration. In addition, we looked at a variety of documents relating to the management of the service, including quality monitoring checks and we confirmed the safe recruitment of staff members.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 24 July 2021

About the service

Headway Shropshire is a domiciliary care agency that provides personal care and support to people with acquired brain injury, living in their own homes in the community. At the time of our inspection eight people were receiving the regulated activity of personal care.

Not everyone using Headway Shropshire received a regulated activity. CQC only inspects the service received by people provided with 'personal care': for example, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

People’s experience of using this service and what we found

People did not always receive consistent care and support from staff.

People were often supported by staff who had not been introduced to them and did not know their specific needs or preferences.

The provider had assessed the risks to people associated with their care and support. Although most staff members were knowledgeable about these risks there were instances staff had been deployed to support people without the necessary training.

People, their relatives and staff members were not always informed about changes within the organisation or management structure. Staff members were unsure what the vision of Headway Shropshire was or the organisations goals for supporting people.

Staff members did not always feel supported by Headway Shropshire. Although, supervision sessions were arranged for staff members, some felt unsupported and isolated.

The provider had systems in place to review the quality of support they provided. However, these systems needed to be developed in order to ensure people received care based on their preferences and their current needs.

Not everyone’s care and support plans reflected their current needs or preferences.

People were protected from the risks of ill-treatment and abuse as the staff team had been trained to recognise potential signs of abuse and understood what to do to if they suspected wrongdoing.

When required, people received safe support with their medicines by staff members who had been trained and assessed as competent. Staff members followed effective infection prevention and control procedures when supporting people.

People were supported to have maximum choice and control of their lives and the provider supported them in the least restrictive way possible and in their best interests; the application of the policies and systems supported good practice.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 August 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

However, the service remains rated requires improvement. This service has been rated requires improvement for two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Headway Shropshire on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.