Homecare Northwest Limited

Updated 11 April 2018

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.

The inspection took place on 1, 2 and 5 March, 2018 and was announced.

The registered provider was given 48 hours’ notice prior to the inspection visit. Prior notice is provided because the location provides a domiciliary care service and we needed to be sure that staff would be available on the day.

The inspection team consisted of two adult social care inspectors and an ‘Expert by Experience’. An ‘Expert by Experience’ is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection visit we reviewed the information which was held about Homecare Northwest Ltd. This included notifications we had received from the registered provider such as incidents which had occurred in relation to the people who were being supported. A notification is information about important events which the service is required to send to us by law.

A Provider Information Return (PIR) was received prior to the inspection. This is the form that asks the provider to give some key information in relation to the service, what the service does well and what improvements need to be made. We also contacted commissioners and the local authority prior to the inspection. We used all of this information to plan how the inspection should be conducted.

During the inspection we spoke with the deputy manager, seven people who were being supported, four relatives and five members of staff. We also spent time reviewing specific records and documents, including four care records of people who were receiving support, four staff personnel files, staff training records, medication administration records and audits, complaints, accidents and incidents, health and safety records, a range of different policies and procedures and other documentation relating to the overall management of the service.

Updated 11 April 2018

This inspection took place on 1, 2 and 5 March, 2018 and was announced.

Homecare Northwest Ltd is a domiciliary care agency. It provides care to people living in their own houses and flats in the community. It provides a service to young and older adults. At the time of the inspection the registered provider was providing support to 50 people.

Not everyone using Homecare Northwest Ltd receives regulated activity; the Care Quality Commission only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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

The registered provider had a number of quality assurance processes in place. Such measures ensure that people receive a safe level of care and support in relation to their support needs. Different assurance processes included ‘spot checks’, medication and care plan audits, accident and incident records, ‘review meetings’ as well as staff and client questionnaires. We did discuss with the deputy manager at the time of the inspection that some areas of quality assurance required improvement.

Medication processes were reviewed during the inspection. People who were being supported with their medication had the relevant care plan and risk assessment in place. People had signed a consent form which allowed care staff to support with medication administration. Care staff had received the relevant medication training and staff were familiar with the health care needs of people they supported. However, we did find a number of medication recording errors which needed to be discussed with the deputy manager at the time of the inspection.

Policies and procedures were reviewed during the inspection. A number of the policies did not contain the correct information in relation to the Health and Social Care Act, 2008. Following the inspection we received copies of all up to date and reviewed policies which contained all the relevant and necessary information.

There was a health and safety policy and procedure that staff were complying with, staff were provided with personal protective equipment (PPE) and they were aware infection prevention control measures which needed to be complied with.

Staff expressed that they were aware of safeguarding and whistleblowing procedures. Staff explained their understanding of such policies and how these could protect people from harm and abuse.

Accident and incidents were routinely recorded and monitored. An accident and incident matrix had been devised as a measure to establish trends and manage any identified risks.

Care plans and risk assessments were reviewed during the inspection. Records contained up to date and relevant information and were reviewed on a monthly basis. Staff expressed that records enabled them to provide the level of support which was required.

Care plans were individually tailored and a ‘person centred’ approach to care was evident throughout the records we reviewed. People expressed that staff were familiar with their support needs and always provided care and support in a respectful and dignified way.

Recruitment processes were reviewed during the inspection. All staff who were working for the registered provider had suitable references and disclosure barring system checks (DBS) in place. DBS checks ensure that staff who are employed are suitable to work within a health and social care setting. This enables the registered manager to assess level of suitability for working with vulnerable adults.

Staff expressed how they were supported in their roles. Staff received regular supervision and annual appraisals were taking place. Training was regularly provided which helped to equip staff with the necessary skills and qualities which were required.

There was evidence to suggest that the registered provider was operating in line with the principles of the Mental Capacity Act, 2005 (MCA). People who were being supported provided their ‘consent’ to receive support and were involved in all decisions in relation to the care which was provided.

People’s day to day health needs were being supported. Appropriate referrals were taking place; we reviewed correspondence between external healthcare professionals as well as the necessary risk management tools being used to monitor people’s health and well-being.

The registered provider was aware of their regulatory responsibilities. They understood that CQC needed to be notified of events and incidents that occurred in accordance with the CQC’s statutory notifications procedures. Statutory notifications were being appropriately submitted to CQC as well as the local authority in a timely manner.