30 January 2020
During a routine inspection
Workwise is a domiciliary care agency. The service supports people receiving personal care in their own home. At the time of the inspection, 96 people were receiving support with personal care. 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.
People’s experience of using this service and what we found
‘As needed’ medicines were not managed safely, medicine records did not provide clear guidance to staff. Care plans guided staff on how to meet people’s daily routines and preferences. However, care plans lacked detail on people’s individual health conditions and how staff should respond to these. The registered manager has told us that they intend to resolve this.
Staff had made decisions for people who experienced confusion. However, documentation of people’s ability to make decisions had not followed the principles of the mental capacity act. Systems were in not fully place to clearly assess and support people’s decision making if needed. This puts people at risk of their decision making abilities not being effectively assessed.
The registered manager and staff were aware of their responsibilities and worked hard to create a good quality service. We identified concerns with medicine records, care plans and mental capacity assessments. We also identified concerns with the end of life policy and there was no evidence that people had been asked about their end of life wishes. The registered manager’s oversight and auditing of these areas had not identified these concerns. The concerns highlighted on inspection were responded to promptly and evidence sent that changes were being made. We will review the impact of this at our next inspection.
People told us that they felt safe at the service. Good hygiene practices were followed to keep people safe from the risk of infection. Incidents were reviewed, and action taken to keep people safe.
There were enough staff at the service and staff arrived at calls in a timely way. Some missed calls had occurred at the service, which meant staff had not arrived at the person’s house as expected. The registered manager had reacted appropriately to each circumstance and advised they were working to ensure this did not reoccur.
Most people told us that regular staff attended. These staff knew their needs well and had built a good relationship. People told us that when these staff had annual leave of sickness, new staff were sent to them. People reported that care was still a good quality however these new staff did not know their needs as well. This can have an impact on people who cannot communicate their needs as clearly.
Staff were well trained and received a structured induction to their role. Staff were safely recruited to ensure they were of good character. People were supported to eat and drink a balanced diet. Professional referrals were made if needed. These referrals had a positive impact on people’s well-being.
Staff were caring and kind to people. People were involved with making decisions about their care. Dignity was at the forefront of the service values. The service worked hard to reduce people’s loneliness. Free transport, and social activities were arranged for people. Those people that did not wish to go out, were supported with activities in their home. The service supported people’s complex communication needs with the use of accessible information.
Rating at last inspection
The last rating for this service was Outstanding (published 15 June 2017).
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.