Background to this inspection
Updated
13 November 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. 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
On the first day the inspection team consisted of one inspector and an Expert by Experience who contacted people by telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. On day two the inspection team remained the same with the Expert by Experience making further calls to people.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection site visit activity started on 17 October 2019 and ended on 18 October 2019. We visited the office location on both dates.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with nine people who used the service and five relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, regional support manager, operations manager, care coordinator and care workers.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, surveys and weekly reports were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also received written feedback from a healthcare professional who regularly works alongside the service.
Updated
13 November 2019
About the service
Wareham Care at Home is registered to provide personal care to people living in their own homes. At the time of the inspection the service provided personal care and support to 61 people living in their own homes in the Wareham and surrounding areas.
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 previous inspection the service was also providing a live-in carers service. The live-in carer service was now delivered from one of the provider’s other registered locations.
People’s experience of using the service and what we found
People expressed dissatisfaction they no longer received rotas and therefore did not always know who was coming and at what time. Since December 2018, following consultation with local authority commissioners, the service had introduced two hour visit windows. This had been communicated to people by letter at the time. We raised this with the management who immediately scheduled telephone calls and visits to people to discuss their concerns and look for a mutual resolution.
People told us they felt safe. Staff had an improved understanding of the risks in people’s lives and how to work alongside them to minimise the risks. When risks were identified information was shared appropriately and in a timely way. Additionally, staff demonstrated knowledge of the signs and symptoms people could be showing should they be experiencing harm and abuse and how to raise concerns internally and to external agencies.
Since the previous inspection care plans had been improved. These were now more personalised and contained detailed information to help staff get to know people well and meet their needs competently. This included advice on particular conditions. Staff received an induction, competency assessments and a consistent programme of spot checks to ensure they were delivering care in line with best practice standards.
Since the previous inspection quality assurance systems had also been improved and now provided sufficient oversight of service delivery. Staff undertaking audits had received appropriate training.
Staff understood the principles of the Mental Capacity Act 2005 (MCA) and considered these consistently when supporting people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People and relatives felt staff were kind, caring and respectful. One person said, “I’m well pleased with the way things are going. They (staff) are very good.” A relative had fedback that the care provided to their family member was ‘second to none.’
Staff felt supported, motivated and valued by the registered manager. The office and staff team said communication had improved between them and told us they got on well. The registered manager had helped create a friendly, vibrant and open culture at the service.
The service understood the benefits to people of close liaison with other agencies and organisations such as GPs, fire service, hospital discharge team and local housing associations. The service had recognised the part they could play in maintaining and improving people’s health and wellbeing.
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 20 October 2018) 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.
Why we inspected
This was a planned inspection based on the previous rating.
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.