Background to this inspection
Updated
1 December 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 15 September 2017 and was unannounced. We visited the office on this date and after this we met with people in their own homes on 19 and 20 September 2017 and at an arranged meeting on 20 September 2017.
The inspection was carried out by an adult social care inspector.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service, such as notifications we had received, from the registered provider. A notification is information about important events which the service is required to send us by law. We planned the inspection using this information. We also spoke with social workers, health care practitioners and commissioners of care.
We met with nine people in their own homes and with seven people who came to the office to meet with us. We also met two relatives during our visits.
We spoke with the registered manager, both location managers and with three of the service's deputy managers. We met ten staff, either in the office or in people's homes. We also had some contact with staff by telephone. We met a project worker from the local authority during the inspection.
We read five care files in the office using both paper files and electronic case notes. We read four different case files in people's homes.
We looked at six staff recruitment, supervision and training files in the main office.
We looked at risk assessments and we also looked at risk management plans for care and support. We saw a number of these that related to supported living settings where people were tenants but who needed support within these environments.
We saw a range of quality management documents which included audits and reports. We also saw training records, supervision notes and training plans.
Updated
1 December 2017
This was an unannounced inspection which started on 15 September 2017. We visited the main office on that day and then, by arrangement, we visited people in their own homes on 19 and 20 September 2017. We also met with a group of people on 20 September 2017 in the office at their request.
Walsingham West Cumbria Domiciliary Care provides packages of care to people with learning disability who live in their own properties in the community. Some people live in shared houses in schemes called 'supported living' and other people live alone with support. When we visited there were twenty seven properties where thirty nine people were supported by the service provider. Walsingham provides residential accommodation and community support throughout England. This service delivery was based in an office in Workington.
The service employed a registered manager who was suitably qualified and experienced in managing a domiciliary care service. 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
A number of changes had been put in place since the registered manager took over the service. The auditing of records was done in detail, people given the opportunity to voice their opinions and action taken when things needed to improve. We saw that talking with people and with staff, checking audits and analysing incidents had led to new focus groups, changes to management work patterns, changes to care planning and new ways of supporting people with medicines. Discussions were being held on introducing assistive technology that would help people live more independently.
We also noted that the provider had identified the lack of good quality properties to rent. They had purchased a number of properties which a different company ran for the tenants. This meant that people had moved to more appropriate environments. We saw that this had made significant changes to a number of people who were now living more independently.
Suitable risk assessments were in place. There had been no reportable accidents or incidents in the service but staff understood how to deal with any issues.
Good arrangements were in place to ensure that new staff were recruited appropriately. Established staff were monitored and any problems of care delivery were dealt with through supervision or disciplinary actions.
People had their medicines reviewed on a regular basis and quality systems were in place to ensure that staff understood how to administer medicines. Staff had received suitable training. Errors were dealt with appropriately.
Staff were aware of how to prevent cross infection and the provider had suitable policies and procedures in place
Staff were given suitable levels of training and support to ensure that each of them were helped to develop in their role. Staff received regular supervision, their practice was observed and they had annual appraisals.
The registered manager understood her responsibilities under the Mental Capacity Act 2005 and was aware of how this applied to people living in their own properties. Some people in the service did have their liberty restricted for their safety. This was done legally and in the least restrictive way possible. 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.
People were supported to access health care and to follow healthy eating and exercise so that they could stay as well as possible. Staff gave people a lot of support to help them to maintain a healthy weight.
The registered manager was working with the landlord of the main office as people who used services wanted improvements to disabled access. She was also helping people to talk to their landlord about some problems in two supported living settings.
We met very caring and committed staff members who could communicate well with the people they supported. Staff understood the needs of the people they supported and they encouraged them to have meaningful lives. People were encouraged to be as independent as possible.
Good assessment of need was in place. Staff worked with health and social care professionals to understand what people needed and wanted. They did, however, focus on the person themselves and all care plans were written positively and with a person centred approach.
People were supported to follow their own interests, activities and hobbies. They also had the opportunity to socialise with other people that Walsingham supported.