- Homecare service
Winsor Care Services
Report from 11 March 2024 assessment
Contents
On this page
- Overview
- Assessing needs
- Delivering evidence-based care and treatment
- How staff, teams and services work together
- Supporting people to live healthier lives
- Monitoring and improving outcomes
- Consent to care and treatment
Effective
We found that peoples needs were not always accurately assessed and often the local authority assessment had been relied upon for information rather than the provider gathering information themselves. Staff did not always feel they could rely on assessments for accurate information but were vigilant at gathering peoples preferences from people directly. This contributed to the breach we found of Regulation 12. People did not always recall having a face to face assessment with the provider but were confident in the carers listening to them and how they wanted their care delivered. We found that the staff worked well with the office staff and other services to help people receive effective care.
This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Assessing needs
People did not have accounts of being involved in a face-to-face assessment with the provider. One relative told us “Yes, a social worker came round to the house to complete it and they appointed [provider] for us.”. When asked if they contributed to their care plan, people told us "Yes, I can talk to them about everything, they always do their best for me and do whatever they can for me" and "they are very willing to listen to my thoughts and concerns". People did not mention being part of a formal assessment of their care needs.
The registered manager and consultant recognised that there were not thorough assessments in place for all people they support. For example, where someone had a piece of medical equipment to aid them, this had not been assessed. We were assured that risks had been mitigated by carers being provided with appropriate tasks on their devices. The consultant for the provider told us, “Care plans and risk assessments are all being reviewed and improved. This is a work in progress.” Staff knew to refer to the documents to establish peoples assessed needs "I read their documents to find out their likes and dislikes and any medical conditions that they have." and "I look at their care plans and communicate with them. I read any assessments that have been completed if they are a new client." Staff told us they were not entirely dependant on peoples care plans for accurate personalised information “We get given a care plan to follow but sometimes when you arrive at the house the client tells us something totally different…I get to know their preferences and how they like things done so I can follow the care plan but still do what they want and make it personal to them.”
The provider had been requested at times to begin care at short notice and would request information from the hospital or local authority to ensure they were aware of peoples needs before they began providing care. The provider had completed their own assessments but care was reviewed by carers delivering care, providing feedback to the office and having documents updated. There was not a thorough initial assessment for all people completed face to face with the provider. However, they had not taken on new service users since the last inspection and so there had not been the opportunity to demonstrate a new assessment. We saw an initial assessment template which showed that all necessary information would be captured.
Delivering evidence-based care and treatment
We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.
How staff, teams and services work together
People and relatives told us that staff were aware of when to involve other services. One relative told us, “They know that my wife has visits from the district nurse to give her insulin and they often say you may want to pass this on to the nurse when she comes.” Another relative told us, “if there is anything that needs to be addressed, they tell us, and we inform the GP as we are responsible for everything medical for mum.”
Staff gave examples of how they communicate with professionals and the office staff to coordinate peoples care and share information. One staff member told us, “When I see something is wrong or I find a service user not well. If I can get the contact number for the GP, I will ring them and then ring my line manager and the office to let them know.” The registered manager told us that a staff member can call the office or make a note on the system that a referral is needed and the office staff complete this. They also told us that the grab sheets would enable emergency services to know about people quickly and efficiently.
Feedback from professionals was that the provider was good at communicating any issues or changes in need and made appropriate referrals as necessary. They told us referrals were made, "To the GP, pharmacy and OT; also check with ASC and family to clarify.". They told us this included "medication not delivered, client not well, reduced mobility and onward referrals". Professional feedback was that there was collaborative working. An involved professional told us, "a carer is present when social care reviews, GP or district nurse home visits are carried out."
We saw records of the provider following up with health professionals and social workers to ensure their needs were met. For example, a staff member had raised concerns with the provider that a person’s dentures were no longer suitable. The provider made contact with health professionals to seek a follow up appointment on the persons behalf and with their consent. We saw that people had contact details for relevant professionals on their records and we saw communication logs keeping records of correspondence. We saw evidence that the provider had been engaging with local authority to improve the quality of the service.
Supporting people to live healthier lives
We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.
Monitoring and improving outcomes
We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.
Consent to care and treatment
We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.