Archived: Westcountry Home Care Limited

Updated 11 October 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 checked 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 4 and 5 September 2017 and was unannounced. The inspection team consisted of one inspector and one expert by experience. The expert by experience had experience of supporting people who accessed service for older persons.

The service was previously inspected in August and September 2015 when it was found to be Good over all but requires improvement in relation to our question, ‘Is the service responsive?’

Prior to the inspection we reviewed the Provider Information Record (PIR) and previous inspection reports. The PIR 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 and notifications we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we visited two people in their own homes and spoke with the 11 people who used the service and four relatives by telephone. We also spoke with seven members of care staff, deputy manager and the registered manager. In addition, a postal survey was sent to 50 people who used the service and we received 12 responses. We also inspected a range of records. These included four care plans, four staff files, training records, staff duty rotas, meeting minutes and the services policies and procedures.

Updated 11 October 2017

Westcountry Home Care provides personal care to people living in their own homes in North Cornwall from its office in Launceston. At the time of this inspection the service was supporting approximately 60 people and employed around 25 care staff. The service provided domiciliary care visit at keys times throughout the day. During these visits staff assisted people with specific tasks or activities to enable people to continue to live at home as independently as possible.

The service’s was led by a registered manager who is also the providers nominated individual with responsibilities for overseeing the performance of the providers other registered services. The day to day leadership of the service was normally the responsibility of the service’s care manager who was supported by a deputy. The care manager had resigned prior to the inspection and appropriate arrangement had been made to ensure the staff team were supported while a new manager was recruited. On the day of our inspection the new care manager joined the service.

At our previous inspection in 2015 we found that although the service was good overall improvements were required in relation to our question is the service responsive? This was because people’s care plans were not always detailed which meant staff did not always have the information they needed to support them.

At this inspection we found the quality of people’s care plans had improved. Detailed assessments of individual needs had been completed before the initial care visit. Information gathered during the assessment process had been used to develop detailed and informative care plans. These documents now gave staff guidance on how the person preferred to be supported and detailed instructions on how to provide their care. Care plans were available in each person home and staff told us, “They have enough information. It lists everything you have to do during the visit.” People’s care plans were regularly updated to ensure they accurately reflected people current care needs. People were involved in this process and able to request changes to both the timing of visits and the contents of their care plans.

All staff had been trained in how to support people with their medicines. Daily care records included details of the support each person had received with their medicines. However, these records did not include details of which medicines the person had been supported with. We have recommended the service reviews its processes to ensure they reflect recently issued guidance.

Everyone who responded to our survey reported that their staff were kind and caring. People and their relatives were complementary of the care and support provided. Their comments included, “I could not do without them. They are good”, “[The staff] are great, very helpful”, “You could not wish for a better team than they have got there” and “I’m very pleased, more than satisfied and couldn’t manage without them.”

There were enough staff available at the time of our inspection to provide all planned care visits. The service had recently experienced issues due to unexpected levels of staff sickness during the summer holidays. Appropriate action had been taken to address this situation with support from the provider’s other local services. One person told us “They had a bit of a hit by a summer bug, they were very short staffed but still managed to turn up.” A targeted recruitment programme was planned to address these issues and the service was only accepting new care packages where staffing capacity was available.

We received some mixed feedback in relation to the pace at which support was provided and staff arrival times. Some people felt staff were under time pressure while others reported, “They do a good job, they don’t rush me”, We reviewed the service’s staff rotas and daily care records and found that people normally received their visits on time and for the correct duration. Relative told us, “Time is not a problem” and staff reported that they had sufficient time with people to meet their needs.

People were confident they would receive all of their planned care visits. However, staff reported that one visit had been recently missed. This was because the staff involved had not read the rota correctly. Records showed this incident had been fully investigated by managers.

Staff had received safeguarding training and understood their role in protecting people from abuse and avoidable harm. Information on local safeguarding procedures was included in each person care plan and available to staff via posters in the service office. There were risk management systems in place and records showed risks in relation to both the environment and the person’s specific needs had been assessed. Where risks were identified staff were provided with guidance on how to protect people and themselves.

Staff understood the requirements of The Mental Capacity Act 2005 and the importance of respecting people’s decisions and choices. Staff described how they supported people to make decisions. Their comments included, “I involve my clients in everything. I like to make sure I offer three choices. I think people like to be involved.”

People told us, “I feel that they all know what they’re doing.” Records showed staff were trained and sufficiently skilled to meet people’s needs. Staff told us “I have had loads of training since I started” and The training is very good, we do it every year.”

Recruitment practices were robust and all new staff received induction training and completed a number of shadowing shifts before providing care independently. People told us “The new ones come and watch a few times before doing the visit” while staff said, “I did a week of training and then shadowing for a week I think” and “I did two weeks of shadowing. Initially I just watched, then slowly I became more hands on as I knew what to do.” Staff new to the care sector also completed the care certificate to give them a good understanding of current best practice.

There were appropriate quality assurance systems in place. People were regularly asked for their feedback on the service’s performance and where any issues were raised these were acted upon. Initial responses to a postal survey underway at the time of our inspection were positive and people consistently told us they were happy with the level of care and support provided. People understood how to make complaints and there were system in place to ensure any complaints were investigated and resolved.

There was a positive culture within the staff team and staff told us they were well supported by their managers. Staff told us, “We are a team and we work well together” and “I think it is a good company in care.” Team meetings were held regularly and all staff received regular supervision. A newsletter was produced each week to ensure all staff were kept up to date with any changes within the organisation.