Archived: Wii Care Limited

Updated 15 August 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 12 July 2017 and was unannounced.

The inspection team consisted of two inspectors.

Before the inspection, we reviewed previous inspection reports, information from whistle blowers, complaints and concerns that had been passed to us by people, relatives and the local authorities.

We spoke with three staff including care staff and the registered manager, who was also the provider.

We telephoned two people and met with two people and one relative to ask them about their views and experiences of receiving care.

We contacted health and social care professionals including local authorities care managers to obtain feedback about their experience of the service.

We looked at records held by the provider and care records. These included five people’s care records, medicines records, risk assessments, staff rotas, four staff recruitment records, meeting minutes, quality audits, policies and procedures.

We asked the provider and registered manager to send additional information after the inspection visit, including training records, policies and some contact telephone numbers. The information we requested was sent to us in a timely manner.

Updated 15 August 2017

This inspection was carried out on 12 July 2017. The inspection was unannounced.

Wii Care Limited was registered to provide personal care services to people living in their own homes, mainly in the Medway area. There was an office base in Rochester in Kent. When we last inspected the service there were 82 people receiving a service. At this inspection there were five people receiving a service. Two people lived with relatives and three others lived alone in the community.

The service 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. The registered manager was also the registered provider of the service.

At our previous inspection on 16 and 19 January 2017 we found breaches of Regulations 9, 10, 11, 12, 16, 17, 18, 19 and 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found a breach of Regulation 18 of The Care Quality Commission (Registration) Regulations 2009. The provider had failed to provide care and support which met people's needs and preferences. Medicines had not been properly managed. Risks to people had not been adequately assessed. The provider had failed to carry out adequate employment checks. Consent to provide care and treatment had not been undertaken with the relevant persons. Complaints had not been dealt with effectively. Systems to monitor quality and safety were not always operated effectively and records were not always accurate and complete. Sufficient numbers of staff were not deployed to be able to provide the assessed personal care needs of people using the service. The provider had failed to provide care and treatment to meet people’s needs. People had not always been treated with dignity and respect. The provider had failed to display their rating and had failed to notify CQC of events and incidents. We asked the provider to take action to meet Regulations 11, 19 and 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of The Care Quality Commission (Registration) Regulations 2009. We took action against the provider in relation to Regulations 9, 12, 16, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We received an action plan on 30 March 2017 which stated that the provider had met Regulations 11 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of The Care Quality Commission (Registration) Regulations 2009 by 01 March 2017. They planned to meet Regulation 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by 31 May 2017. At this inspection we found the provider had not implemented all of the improvements they had identified in their action plan.

Medicines records, risk assessments and administration required improvement. When medicines had special instructions for administration these were not included in the information for staff.

Risk assessments were in place to help to keep people safe. However, the risks identified and the control measures recorded to manage the risks were basic and generalised. The risk assessments had not been personalised and did not mitigate all the risks associated with people’s health and care.

The provider and registered manager had made improvements to the processes in place to monitor the quality and safety of the service provided. However, further improvements were required to ensure the provider and registered manager continued to improve the service. None of the issues we found during our inspection had been picked up by the provider and registered manager. Records, documents and policies were not all accurate.

The provider and registered manager had carried out sufficient checks on new staff before they started employment to ensure they were suitable to work with vulnerable people. However, two out of four staff files contained missing and inaccurate information which put the quality of the checks carried out in doubt.

The provider had safeguarding procedures in place for staff to follow to keep people safe. Staff knew what signs to look out for that might suggest people were at risk of harm. Staff were able to describe what they would do if they had concerns and who they would report these to. The provider and registered manager did not have a copy of the local authorities safeguarding protocols, policies and procedures. We made a recommendation about this.

People’s capacity to make their own choices and decisions had been considered following the principles of the Mental Capacity Act 2005. However capacity assessments conflicted with information about the person which had been detailed in their care plan. Capacity assessments were not decision specific. We made a recommendation about this.

People’s needs had been assessed to identify the care and support they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. People’s care plans detailed what staff needed to do for a person. The care plans did not always include information about their life history and were not always person centred. We made a recommendation about this.

Staff had received training relevant to their roles. One staff member had not attended training relating to all of the assessed needs of a person they worked with on a regular basis. We made a recommendation about this.

There were suitable numbers of staff deployed on shift to meet people’s needs. Staff had adequate time on their schedules to provide people their assessed care needs and had time to travel to the next person without rushing or cutting people’s care short.

Staff received support through one to one supervision meetings. Staff competency to perform their role was checked by the training manager to ensure training delivered had been put into practice.

People told us they thought the staff were caring and they enjoyed their visits. People were given the time and care they needed to be able to maintain their independence and dignity.

Staff supported people whilst maintaining their privacy. Confidential records were securely stored.

Complaints had been adequately recorded, investigated and managed by the provider and registered manager. A complaints procedure was in place detailing the process of how to make a complaint and how it would be handled and responded to.

People’s views and experiences were sought through review meetings and through surveys.

People were supported to be as independent as possible.

Staff felt well supported by the provider and registered manager. They felt they could raise concerns and they would be listened to. They were able to freely access the provider and registered manager when they needed to and we saw that staff visited the office to do this.

Relatives told us that staff were kind, caring and communicated well with them.

People and their relatives had been involved with planning their own care. Staff treated people with dignity and respect.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.