Archived: WarrenCare Limited

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service met all relevant fundamental standards.

A registered manager was in post. 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.

People and their relatives told us that the service was safe. The service maintained effective systems to safeguard people from abuse. Staff were aware of what to look out for and how to report any concerns.

Staff were safely recruited and deployed in sufficient numbers to provide safe, consistent care and support. The employment records for staff were maintained to a high level and showed clear evidence of employment histories, references and checks.

The majority of medicines were safely stored and administered in accordance with best-practice. Staff were trained in administration. However, we did see examples where this was not the case. The registered manager had already identified a training need in relation to medicines’ errors and had organised additional training. There was no evidence that any errors had been significant or had resulted in harm being caused.

Procedures in place reduced the risk of infection. Staff were clear about the need to use personal protective equipment when providing personal care.

People’s needs were assessed in sufficient detail to inform the delivery of care. Care and support were delivered in line with current legislation and best-practice.

The service ensured that staff were trained to a high standard in appropriate subjects. This training was subject to regular review to ensure that staff were equipped to provide effective care and support.

People were supported to eat and drink in accordance with their needs. We saw evidence that staff worked with relatives to ensure that people had access to nutritious meals that met their preferences.

People told us that staff treated them with kindness and respect and we saw this when we visited people receiving care. It was clear that staff knew people, their needs and preferences well and provided care accordingly. We saw staff talking to people in a gentle, knowledgeable and supportive manner about their care needs, families and other things of interest.

People were actively involved in decisions about their care. Staff took time to explain important information and offer choices. This was achieved by talking face to face and making use of different forms of communication where required.

It was clear from care records and discussions with people that their care needs were met in a personalised way. Each person had different preferences and goals that were reflected in their care records.

The majority of people that used the service had specific needs in relation to equality and diversity. We saw that people’s needs were considered as part of the planning process in relation to; disability, age and religion as well as other protected characteristics.

We checked the records in relation to concerns and complaints. There were 26 complaints recorded in 2017. Each had been addressed in accordance with the provider’s policy and included a detailed, written response.

The majority of people spoke positively about the management of the service and the approachability of senior staff. However, there were a small number of concerns raised about the quality and timeliness of communication by some people using the service and staff. We raised this matter with the registered manager who had already recognised an issue and taken measures to improve practice.

WarrenCare had a robust performance framework which helped to clearly define roles and responsibilities. A substantial and regularly updated set of policies and procedures provided guidance to staff regarding expectations and performance. We saw clear evidence that staff had been challenged when their performance did not meet the required standards.

The service had used safety and quality audits to identify and address issues relating to; staff conduct, medication errors and missed calls. Information had been used effectively to improve practice and to inform further development.

Further information is in the detailed findings below.

WarrenCare provides domiciliary care services to 462 people living in their own homes, outreach services for thirteen children and 68 adults and supported living services for ten people.

At the time of the inspection a registered manager was in post. 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.

We asked people about the safety of services. Each of the people that we spoke with told us that they felt the service they received was safe.

The provider had a range of systems and procedures in place which allowed people using the services, their relatives and staff to raise any concerns. Evidence of these systems was made available during the inspection.

The care files that we saw showed clear evidence risk had been assessed and reviewed regularly.

Incidents and accidents were subject to a formal review process which included; the production of a report, a meeting with any staff involved and an analysis that was shared with the manager.

Prior to the inspection we had received information of concern relating to staffing levels and in particular to the impact that staff shortages had on the continuity of staffing. The majority of people that we spoke with were happy with staffing levels and the continuity of staffing. We saw evidence that there was an ongoing programme of recruitment and induction.

Staff had been recruited and trained to ensure that they had the rights skills and experience to meet people’s needs. Staff were required to complete an induction programme which was aligned to the Care Certificate.

People were supported to maintain good health through regular contact and review with a range of healthcare professionals.

We were unable to observe the delivery of care, but people spoke positively about the way in which care was delivered. The staff that we spoke with knew the people that they cared for and their needs in appropriate detail. The care records that we saw used language which was respectful and professional when describing people and the care provided.

People were given choice about the gender of their care staff and the times when staff provided care. Both staff and relatives noted that this choice was restricted when staffing numbers were low or other priorities took precedence.

People using the service and their relatives were encouraged to provide feedback to the organisation through informal and formal mechanisms.

The staff that we spoke with enjoyed working for the organisation and felt supported. Staff were encouraged to give feedback on their experiences and make suggestions for development.

The registered manager and supervisors were clearly aware of the day to day culture and issues within the service. We saw that they knew the people using the service and their staff well. The registered manager was available to members of the staff team throughout the inspection and offered guidance and support appropriately. The registered manager had sufficient resources available to them to monitor quality and drive improvement. These resources included specialist support with recruitment and staff engagement and a range of electronic systems which captured and shared important information.