Background to this inspection
Updated
11 August 2023
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
The inspection was carried out by 3 inspectors and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave a period of notice for the inspection. This was because it was a large service and consent from people and relatives for us to speak with them needed to be sought.
Inspection activity started on 29 June 2023 and ended on 20 July 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. During the inspection the provider completed the PIR and this was reviewed as part of the inspection process.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. Inspection activity began on the 26 June and finished on the 20 July 2023. During the inspection we spoke with 19 people who used the service and 12 relatives of people using the service. We spoke with 13 staff, this included the registered manager, the regional manager, 10 care staff and an administrator. We received written feedback from 4 care staff. We reviewed 7 care plans and 12 medicine records. We analysed data from call records and a variety of records relating to the management of the service were reviewed.
Updated
11 August 2023
About the service
Westminster Homecare Limited (Norwich) is a domiciliary care service providing personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection there were 68 people receiving the regulated activity of personal care.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not provide care or support to autistic people or anybody with a learning disability. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
Right Support: Model of Care and setting that maximises people’s choice, control, and independence
Systems were in place to collate people's feedback on the service they received. Some people felt communication needed to improve around changes to their care calls and the provision of a rota for their calls. We have recommended the provider review this area. The provider had implemented a system to ensure calls were monitored live. This system supported calls being on time and ensured no missed calls occurred.
Right Care: Care is person-centred and promotes people’s dignity, privacy, and human rights
People were supported to stay safe. Safeguarding concerns were identified and acted on. People received their medicines as prescribed. Infection control risks were responded to appropriately and staff were provided with personal protective equipment.
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive, and empowered lives.
Some people felt newer staff did not always understand how to support them. We have recommended the provider review this area further. The management team had good oversight of quality and risks within the service. Effective governance systems were in place. The management team were keen to develop and improve the service. They engaged effectively with external resources to help support this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 11 June 2021).
Why we inspected
We received information that indicated improvements had been made in relation to safe and well-led. As a result, we undertook a focused inspection to review the key questions in these areas only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
Recommendations
We have made two recommendations regarding the communication of call times and reviewing the competency of new staff.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.