All inspections: Waverley Community Care (Guildford & South West Surrey)

All Inspections

Waverley Community Care is a domiciliary care agency which provides care to people living in their homes. The agency provides a range of services, but at the time of this inspection it was primarily to older people with physical health needs and adults who required mental health support. The agency is registered to provide both personal and nursing care, but was not providing the latter at the time of our visit. At the time of our inspection 19 people were receiving a personal care service from the agency.

The inspection took place on 09 November 2016 which included a visit to the service’s office on that date. Calls to people, their relatives and other professionals were made after the visit.

The agency had a registered manager. 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 previously carried out an unannounced comprehensive inspection of this service on 05 October 2015. At that inspection seven breaches of legal requirements were found in respect of good governance, recruitment, safeguarding, record keeping, planning and reviewing care and the management of medicines and risks. As a result the service was rated Requires Improvement and a Warning Notice and six requirement actions for the service to improve were set. Following that inspection, the provider sent us an action plan which identified the steps they intended to take to make the required improvements. We have been in regular contact with the provider since the last inspection who had updated us about the changes they had made. This inspection found that the provider had taken the action they told us they had in respect of each of these areas and as such each requirement action had been met.

The service now had a stronger leadership team which worked collaboratively together to deliver effective care. The collective professional qualifications of the management team enabled people’s specialist needs to be met by staff who were well trained and supported.

People received support from a regular team of care workers who knew and understood their needs. People appreciated consistent support from the same staff with whom they had built a rapport and trusted.

The service had improved its systems for recruiting new staff and now took appropriate steps to ensure that staff were properly checked and vetted prior to being employed. Once employed, staff completed a comprehensive programme of induction and training to ensure they had the necessary skills and experience to meet people’s needs.

People’s needs and homes were fully assessed before care was provided. As such, any risks associated with their care were now identified and managed safely. The service had appropriate systems to safeguard people from the risk of harm or abuse and staff were knowledgeable about how to keep protect people and keep them safe.

The service was responsive to changes in people’s needs and tailored their services accordingly. People were involved in the planning and reviewing of their care and supported to be as independent as possible. Staff respected people and understood the importance of gaining consent from people. Staff demonstrated an awareness of the Mental Capacity Act 2005 and knew what to do if a person refused to accept their care.

Staff were kind and compassionate and demonstrated the values of the agency to provide caring support. As such, people received care that was provided in a respectful way that promoted their privacy and dignity. The agency created social opportunities for those people at risk of loneliness and isolation.

People were supported to maintain good health. The service worked in partnership with a range of other healthcare professionals to provide a holistic approach to care. Where people were supported with their medicines, this was done safely.

Staff understood the importance of supporting people to maintain adequate nutrition and hydration. Care plans identified where people needed additional support and steps were taken to ensure these people received sufficient food and fluids each day.

Waverley Community Care now had appropriate systems in place to monitor and improve the quality of its services. People were regularly asked for their feedback and satisfaction surveys sent to people, staff and professionals were used to identify areas for on-going improvement.

The quality of record keeping across the service had improved which enabled the provider to demonstrate the care provided to people.

Waverley Community Care is a domiciliary care agency which provides care to people living in their homes. The agency provides a range of services, but at the time of this inspection it was primarily to older people with physical health needs and adults who require mental health support. The agency is registered to provide both personal and nursing care, but was not providing the latter at the time of our visit.

The inspection took place on 05 October 2015 and was unannounced. Following the inspection we made telephone calls to people who used and were involved with this agency.

Whilst people experienced some good care that enabled them to remain in their own homes, the management of this agency was described as “Chaotic” and communication between the agency and people who used the service required improvement. The agency was not well led and the systems in place to monitor and improve quality and safety were inadequate.

The quality of record keeping across the agency was poor and the provider’s systems to identify and manage the risks associated with this had failed. As such we identified multiple concerns about the way information was gathered, stored and used.

People could not be assured that only suitable staff were employed because the agency had failed to follow appropriate procedures in the recruitment of new staff. Staff had access to a range of training opportunities, but new learning was not routinely checked to ensure it improved staff’s practice and that staff were competent to carry out their roles.

Care staff were knowledgeable about people’s needs and provided flexible and responsive support. Information however was not accurately documented to ensure new staff had guidelines to follow and enable care to be provided consistently. People were not sufficiently involved in the formal planning and reviewing of the care which meant that they did not have always have the opportunity to discuss issues which would improve the support they received. For example, people shared frustrations with us about not knowing which care staff was coming and call times and lengths not always suiting them.

Whilst risks to people and staff were identified and taken seriously, appropriate action had not always been taken to ensure people were fully protected from the risk of harm. Staff had a good understanding about safeguarding, but the agency’s duty to refer concerns to the local authority had not always been done in a timely way.

People appreciated the regularity of a small team of care staff to support them. They consistently described care staff as “Excellent”, “Very kind” and told us that they would frequently “Go above and beyond what was expected.” People liked the fact the new staff were usually introduced to them before they provided support alone.

Other community professionals praised the creative approach to support that the agency provided to people with complex needs or who were resistant to receiving care. Care staff were described as “Genuinely caring” and “Good advocates of people.” We were repeatedly told that the recent employment of a Community Psychiatric Nurse (CPN) to work with people with mental health needs had “Bridged the gap” and really improved the lives of some people who needed a lot of support to live in the community.

The agency supported people in a holistic way and had good links with other healthcare professionals, such as GPs, district nurses and local community teams which helped people to maintain good health.

Staff supported people to retain their independence and lead their lives with choice and control. People said care staff always treated them with dignity and respect. Care staff were able to tell us how they protected people’s privacy and maintained dignity during the provision of care.

We found a number of breaches of regulations. You can see what action we asked the provider to take at the back of this report.

Archived: Waverley Community Care (Guildford & South West Surrey)

All Inspections

9 November 2016

During a routine inspection

05 October 2015

During a routine inspection