Willowbrook Homecare

This service is a domiciliary care agency. It provides personal care to people living in their own houses. The agency also provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. At the time of the inspection, a total of 261 people were receiving a service from the agency.

At the last inspection, in April 2016, the service was rated as overall good, however, we identified one breach of the regulations. This was because the provider had failed to operate a robust recruitment procedure. Following the inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key question of ‘Safe’ to at least good. At this inspection, we found the provider had made the necessary improvements to the recruitment procedure. However, we found some improvements were needed to the management of medicines and the risk assessment process. We have therefore retained the rating of requires improvement in the key question of ‘Safe’, but as we have identified no breaches of the regulations the overall rating remains ‘Good’.

People using the service told us they felt safe and staff treated them well. Safeguarding adults’ procedures were in place and staff understood their responsibilities to safeguard people from abuse. Individual risks had been assessed; however, risks associated with choking and skin integrity had not been fully assessed and documented. There were systems in place to support people with their medicines, however, there were some shortfalls found in the records and the care planning for medicines. We were assured by the registered manager the necessary improvements would be made.

People told us the staff arrived on time and stayed for the agreed amount of time. None of the people spoken with had experienced a missed visit. The registered manager closely monitored any missed visits and there was evidence of investigations following missed visits. According to the central register, there had been eight missed visits in 2018. An electronic call monitoring system was in place to monitor visits.

Staff members told us they received effective training to meet people's needs. An induction and training programme was in place for all staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, the principles of the Mental Capacity Act were not always evidenced as part of the care planning process. People were supported with their healthcare and nutritional needs as appropriate.

People told us the staff were caring and they respected their rights to privacy, dignity and independence. All people spoken with told us the staff were kind and caring. People told us they were involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people’s needs and wishes. People told us they usually received care from a consistent group of staff. People were aware of the complaints procedure and processes and were confident they would be listened to.

Systems were in place to monitor the quality of the service, which included seeking and responding to feedback from people and their relatives in relation to the standard of care.

Willowbrook Homecare is registered to provide personal care to people living in their own homes. The agency provides a service for people residing in Burnley, Pendle, Hyndburn and Rossendale. The agency also provided extra care support to people living at a housing scheme based in Whitworth. The agency’s office is located in the centre of Oswaldtwistle. At the time of the inspection 187 people were using the service.

The service was managed by 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 last inspected this service on 30 April 2013 and found it was meeting the regulations applicable at the time.

During the inspection, we found there was a breach of one regulation relating to the recruitment of new staff. You can see what action we told the provider to take at the back of the full version of the report. We also made a recommendation in respect of the implementation of the Care Certificate for staff new to a social care setting.

All people told us they felt safe when receiving care from the service. Staff had a good knowledge of how to identify abuse and the action to take if abuse was suspected. We found care was planned and delivered to ensure people were protected against avoidable harm.

People received their medicines safely and were supported to eat and drink in accordance with their care plan. Staff liaised closely with healthcare professionals to ensure people’s healthcare needs were monitored.

There were sufficient staff to cover the care and support needs of people using the service. People told us staff usually arrived on time and did not cut their visits short. Staff were provided with appropriate on-going training and were well supported by the supervisors and the management team. However, the provider had not always operated a robust recruitment procedure and we found some information was missing from two staff members’ records.

Whilst new staff were provided with induction training, which included the provider’s mandatory training and shadowing more experienced staff, we found the Care Certificate had not been implemented. We therefore recommended arrangements were made to introduce the qualification to ensure staff are assessed using nationally recognised standards.

People received safe care and support which reflected their individual preferences, likes and dislikes and promoted their independence. People told us the staff were caring and they respected their rights to privacy, dignity and independence.

People were involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people’s needs and wishes.

Staff understood the relevant requirements of the Mental Capacity Act 2005 and how it applied to people in their care. People's consent was sought before care was given and they made choices and decisions about how this was carried out.

The complaints procedure provided information on the action to take if a person wished to raise any concerns. People were aware of the complaints procedure and processes and were confident they would be listened to.

There was a quality monitoring system in place. The registered person undertook regular audits and spot checks were carried out to observe how the staff delivered care to people. People were asked for their views and feedback was acted upon to maintain or improve the service provided.

We looked at three plans of care at the office and three plans of care, with permission in people's houses. Each person had signed a contract with the agency to agree to the care and times of visits. All the people we spoke with thought they were involved in their care package.

All the people we spoke with knew how to complain if they wished and were provided with contact details for the agency and other organisations should they wish to raise any concerns.

We found that plans of care were detailed for staff to follow and were reviewed to keep care staff updated in order to deliver effective care.