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Westminster Homecare Limited (Luton) Good

Inspection Summary


Overall summary & rating

Good

Updated 25 April 2017

When we inspected the service in November 2015, people’s risk assessments had not all been reviewed and updated to ensure that they remained relevant to people’s needs so that staff provided appropriate and safe care. Staff did not have good understanding of the requirements of the Mental Capacity Act 2015 (MCA) despite being trained. The quality of the service had been affected by the lack of stable leadership. We found improvements had been made during this inspection, but the service needed to improve how people’s care was planned and coordinated, and how staff were supported.

This announced inspection was carried out between 13 January 2017 and 21 February 2017. The service provides care and support to people in their own homes in the community and to those living within two local extra care housing schemes. At the time of the inspection, 129 people were being supported by the service, some of whom may be living with chronic health conditions, physical disabilities and dementia.

The service did not have 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. A new manager had recently been employed, but they left the service within two weeks of being in post. The operations manager was regularly based at the service and provided stability during periods when there had been no manager.

People were safe because the provider had effective systems to keep them safe, and staff had been trained on how to safeguard people. There were individual risk assessments that gave guidance to staff on how risks to people could be minimised. People’s medicines were managed safely and administered in a timely manner by trained staff. The provider had effective recruitment processes in place and there was sufficient numbers of staff to support people safely.

Staff received effective training, support and supervision that enabled them to provide appropriate care to people who used the service. Staff now understood their roles and responsibilities in ensuring that people consented to their care and support, and that this was provided in accordance with the requirements of the Mental Capacity Act 2005 (MCA). Where required, people were supported to have enough to eat and drink.

Staff were kind and caring towards people they supported. They treated people with respect and supported them to maintain their independence as much as possible. People were happy with how their care was provided and they valued staff’s support. People had developed friendly relationships with staff who supported them regularly.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences and choices. Care plans had been reviewed annually or when people’s needs changed. Staff were responsive to people’s needs and where required, they sought appropriate support from healthcare professionals. The provider had a system to manage people’s complaints and concerns.

The provider had systems to assess and monitor the quality of the service. They encouraged feedback from people, relatives and staff to enable them to continually improve the service. However, most people and staff we spoke with were confident that the service was well managed. They attributed this to the changes in managers in the last couple of years. People and staff did not always find office staff approachable and helpful. The provider made improving this their priority.

Inspection areas

Safe

Good

Updated 25 April 2017

The service was safe.

People felt safe with how staff supported them and there were effective systems in place to safeguard them.

There was enough skilled and experienced staff to support people safely.

People’s medicines were managed safely.

Effective

Good

Updated 25 April 2017

The service was effective.

Staff received regular training and support in order to develop and maintain their skills and knowledge. The requirements of the Mental Capacity Act 2005 were being met.

Staff understood people’s individual needs and provided the support they needed.

People had been supported to maintain their health and wellbeing.

Caring

Good

Updated 25 April 2017

The service was caring.

People were supported by staff who were kind and caring towards them.

Staff respected people’s choices and supported them to maintain their independence.

People were supported in a respectful manner that promoted their privacy and dignity.

Responsive

Good

Updated 25 April 2017

The service was responsive.

People’s care plans took into account their individual needs, preferences and choices.

People and their relatives were involved in planning and reviewing people’s care plans so that their care needs were appropriately met.

The provider had a system to manage people’s complaints and concerns.

Well-led

Requires improvement

Updated 25 April 2017

The service was not always well-led.

Changes in managers meant that the service was not always well managed. People and staff did not always find office staff approachable and helpful.

People had been enabled to routinely share their experiences of the service.

Quality monitoring audits were being completed regularly to assess and monitor the quality of the service.