Whitestone Care Limited

Updated 23 March 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, 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 carried out by one inspector.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people in their own houses and flats. It provides a service to older adults, younger adults, who have physical disabilities, mental frailty and or end of life care needs.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are 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 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. The Inspection site visit activity started on 21 February 2019 and ended on 28 February 2019. We visited the office location on 28 February 2019 to see the registered manager and office staff; and to review care records and policies and procedures.

What we did:

¿Prior to the inspection we requested and received a Provider Information Return (PIR). Providers are required to send us key information about their service, what they do well and improvements they plan to make. This information helps support our inspections. Throughout the inspection we gave the provider and registered manager opportunities to tell us what improvements they had planned.

¿We reviewed notifications and any other information we had received since the last inspection. A notification is information about important events which the service is required to send us by law.

¿Prior to the site visit we spoke with five people and two relatives. Following the site visit we made a further two telephone calls to people. We requested feedback from staff and received 11 emails back from staff. We sought feedback from community professionals who had knowledge of the service.

¿Prior to the site visit we requested information from the provider and received it back in a timely manner.

¿When at the office we spoke with the registered manager, clinical nurse lead and briefly met two staff members.

¿We looked at five people’s care records.

¿We looked at three staff recruitment and training records.

¿We looked at incident and accident records, complaints and complements and reviewed a number of policies including, safeguarding, staff recruitment and mental capacity as examples.

Updated 23 March 2019

About the service:

Whitestone Care is registered to provide personal care to people living in their own homes. At the time of the inspection 22 people were being supported with personal care. Many of them were in receipt of end of life care. The main office is based in Slough, people supported by the service lived within the local area and within an approximate 30 mile radius from the office.

People’s experience of using this service:

¿People and their relatives gave us positive feedback about how they had been supported. Comments included “They [Staff] always have a smile on their face, they put me at ease, they are very gentle” and “I really look forward to them [Staff] coming, they do a good job.”

¿Comments from relatives included “I think my overall experience with them [Staff and company] has been very positive. Every single person [Staff] has been attentive, sensitive and respectful. They are a credit to the industry,” “At a time like this you need lovely people and they are lovely people, very respectful” and “They [Staff] make mum laugh and that means a lot to me, they always talk to her and make her feel valued.”

¿ People told us they were treated with dignity and respect. One person told us “They [Staff] are very respectful, all have been very nice, pleasant and very good.” Another person told us “I honestly cannot fault them [Staff], every carer is respectful and absolutely lovely.”

¿Providers and registered managers are required to notify us of certain incidents or events which have occurred during, or as a result of, the provision of care and support to people. One notifiable event is when an allegation of abuse had been made. We checked our records against other information we had received from local authorities. We had not been notified of two safeguarding events reported to the local authority. However, the provider had taken appropriate action to protect people.

¿Records relating to potential risks to people had not always been recorded. For instance, one person was an insulin dependent diabetic. No additional guidance was available to staff on recognising a possible deterioration in their condition. We have made a recommendation about this in the report.

¿Where people required support with their prescribed medicine this was detailed in their care plan. However, no additional guidance was available for staff on when and how they should administer medicines for occasional use (PRN). We have made a recommendation about this in the report.

¿Records relating to people’s care needs did not always reflect the most up to date information. However, communication with staff ensure people received effective and safe care.

¿Systems were in place to recruit staff through a robust process. The provider had invested into a training suite which was fully equipped so staff could receive hands on training.

¿The registered manager was passionate about providing a high-quality service to people at the end of their life. They told us “I pride myself in my practical skills…I want people to have a peaceful passage. You don’t get a second chance, so whatever I can do to support the staff to provide a dignified service, I will do.”

Rating at last inspection:

The previous inspection was carried out on 28 April 2016 (Published on 17 June 2016). The service was rated Good at the time.

Why we inspected:

The inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Inspections will be carried out to enable us to have an overview of the service, we will use information we receive to inform future inspections.

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