Archived: Waves

Updated 27 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 07 and 08 June 2017. Due to the small size of the service we announced the inspection to make sure someone would be at the service who would be able to facilitate the inspection when we arrived. The inspection team consisted of one adult social care inspector on both days.

We asked the provider to update their Provider Information Return (PIR) prior to this inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan the inspection.

As part of the inspection we reviewed the information we held about the service and requested feedback from other stakeholders. These included Healthwatch Kirklees, the local authority safeguarding team and the Clinical Commissioning Group. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. They did not share any concerns with us.

During the inspection we spoke with two people who used the service. We spoke with the acting manager and the deputy manager, both of whom worked as support workers at Number Six, and one other support worker. The registered manager was away at the time of the inspection; we spoke with her by telephone after the inspection.

As part of the inspection we looked at three people’s care records in detail and selected records from two other people’s care files. We also inspected three staff members’ recruitment, supervision and training documents, two people’s medicines administration records, and various policies and procedures related to the running of the service.

Updated 27 July 2017

We inspected Waves on 07 and 08 June 2017. Because the service is very small, we rang to announce the inspection on the first day so someone would be at the service who would be able to facilitate the inspection when we arrived. Waves respite service is located next door to a day centre run by the same provider with the same name. People, relatives and staff call Waves respite service ‘Number Six’ to differentiate it from the day centre.

Number Six is a respite service providing residential care and one-to-one support for up to one young adult with a learning disability at a time. It is a small, two-bedroomed terraced house not far from the centre of Slaithwaite village. Since the service was registered in 2013 a total of 15 people have received respite care. At the time of this inspection four people were using the service on a weekly or monthly basis for up to two nights at a time.

Number Six was last inspected in December 2014. At that time it was rated as ‘Good’ in all of our five key questions.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At this inspection we found breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014 relating to safe care and treatment, consent, staffing, good governance and fit and proper persons employed. You can see what action we have told the provider to take at the back of the full version of the report.

Record-keeping for medicines management and administration required improvement. Support workers could describe the medicines people needed and when they should be administered.

Not all aspects of the building had been checked for health and safety. The gas safety certificate had expired shortly before the inspection and the building’s fire risk assessment had not been reviewed since 2013.

People chose the support workers they wanted to provide their one-to-one support when they used Number Six for respite. Recruitment records for the service were incomplete.

Support workers had received the training they needed to support people effectively; however, they did not receive regular supervision or annual appraisal. This was noted at the last inspection in December 2014.

Support workers told us they did not think every person had capacity to make all of their own decisions. People’s care records made no reference to their capacity (or otherwise) to consent to the care and treatment they received at Number Six. This included considerations around people’s freedom and liberty.

The service used information provided by people’s relatives and carers as the support plan for each person to guide staff as to the needs of the person. They had not formulated support plans with the people who used the service to ensure plans of care reflected the person’s personal preferences Records showed, and relatives told us, people received support that was person-centred.

The registered manager did not complete audits to monitor the service for safety and quality in order to drive quality improvement.

At the time of this inspection the registered manager was away on a trip of more than 28 consecutive days. They had not informed CQC of this, as is required by the Care Quality Commission (Registration) Regulations 2009.

We recommended the registered manager refreshed their knowledge with respect to the requirements to notify CQC of incidents and changes at the service.

No complaints had been made to the service since the last inspection in December 2014. Relatives told us they felt able to speak to managers about any concerns they might have. People did not have access to an easy to read version of the provider’s complaints policy.

People’s relatives told us they felt their family members were safe at Number Six. Staff members could describe how to recognise and report abuse.

Risks to people had been assessed and control measures put in place, although we did identify one person with a medical condition who did not have support plans in place to guide staff. People were supported to take risks in order to have new experiences and maximise their independence.

People were supported to eat the foods they enjoyed at Number Six. They were encouraged to shop for and cook food with staff, and often went out for meals.

Number Six had been adapted to suit the people who used the service for respite care. We found it to be very homely and welcoming.

People told us they liked their support workers. Their relatives said staff were kind and caring, and helped support their family members to be as independent as they could be.

Support workers could describe people well as individuals. They knew what people liked and disliked and what made them happy. Support workers consulted the person before each period of respite to find out what activities they wanted to do.

People chose the activities they wanted to do when they were at Number Six. Records showed people often went out for walks, to eat, to shop, went to the cinema and went bowling.

Relatives told us they liked the updates they received from support workers about their family member when they were using the respite service.

Staff had regular meetings with managers at Number Six. Records showed they discussed good practice and ideas to improve the service. Staff supported people according to the provider’s vision and values for the service.