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Westminster Homecare Limited (Luton) Good

Reports


Inspection carried out on 13 January 2017

During a routine inspection

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 carried out on 19 November 2015

During a routine inspection

We carried out an announced inspection on 19 November 2015. 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, 209 people were being supported by the service, some of whom may be living with chronic health conditions, physical disabilities and dementia.

During our inspection in March 2015, the provider had not met five regulations. This was because people’s medicines had not always been administered at the right times. The provider’s recruitment processes were not always robust. Staff did not receive regular supervision and had not been positively supported and encouraged to develop their skills. Also, staff did not have good understanding of the requirements of the Mental Capacity Act 2005 (MCA). Late visits by staff often meant that people were not supported at times of their choosing. Action had not been promptly taken to make the required improvements because the service had not been well managed. Following the inspection, the provider had sent us an action plan telling us that they would make the required improvements by 30 September 2015.

The service did not have a registered manager following their resignation. A new manager had recently been employed, but had left within a few days of our inspection. The area manager who had been based at the service since May 2015 in order to drive the required improvements assured us that they would recruit a new manager as soon as possible. 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.

People felt safe and there were systems in place to safeguard them from risk of possible harm.

Some of the people’s risk assessments had been updated so that staff had the information they needed to support people safely and minimise the identified risks. There had been significant improvements in how people’s medicines were being managed and this was a result of a reduction in late or missed visits.

There had been improvements in how staff were recruited and there was sufficient numbers of staff to support people safely. There were plans in place to ensure that staff received regular supervision and effective support. Staff said that the quality of training had improved and there were plans to update each member of staff’s training in the next few weeks.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. However, further training was required in order for them to understand the requirements of the Mental Capacity Act 2005 (MCA).

People said that staff were caring and respectful, and they were supported well to maintain their health and wellbeing.

People’s needs had been assessed, and care plans took account of their individual needs, preferences, and choices. The provider had improved how they dealt with people’s concerns and an increase in office staff meant that telephone calls were answered more quickly.

The provider had a formal process for handling complaints. They regularly sought people’s feedback in order to improve the quality of the service.

There was improvement in how the service assessed and monitored the quality of the service they provided. However, changes in managers meant that they had not fully made all the improvements required to ensure that they provided good quality care to people who used the service. It was for this reason that we were not able to change some of their ratings as we judged that they needed a longer period to fully embed their improved processes.

Inspection carried out on 12 March 2015

During a routine inspection

We carried out this inspection by visiting the office on 12 March 2015. We gave the provider 48 hours’ notice that we were going to visit. This was to enable the provider to tell people who used the service and staff that we were visiting, and to make sure that documentation relating to people’s care was available for review. Following the office visit, we spoke with people who used the service and the care staff by telephone.

The service provides care and support to people in their own homes, some of whom may be living with dementia, chronic conditions and physical disabilities. At the time of the inspection, 185 people were being supported by the service.

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.

Although care plans were detailed and reflected people’s individual needs and preferences, they were not always updated when people’s needs changed.

Some people’s needs were not responded to in a timely way.

Medicines were not managed safely.

There were risk assessments in place that gave guidance to the staff on how risks could be minimised. There were systems in place to safeguard people from the risk of possible harm.

Recruitment processes were not completed effectively to protect people from the risk of being supported by staff who were not suitable.

Staff understood their roles and responsibilities to seek people’s consent to care, but did not have a good understanding of the Mental Capacity Act 2005 (MCA).

The staff did not have effective supervision and support, and not all training was up to date.

People were supported by caring and respectful staff. They were supported to access other health and social care services when required.

The service had a process for managing complaints and concerns.

The manager did not have effective quality monitoring processes in place.

People were not routinely asked for their views on the quality of the service and action was not taken to address all issues that were raised.

During this inspection, we found that the provider was in breach of the Health and Social Care Act (regulated activities) Regulations 2014. You can see the action we have asked them to take at the back of the full report.

Inspection carried out on 9, 16, 17 September 2013

During a routine inspection

We spoke with 15 people who used the service, eight staff and the registered manager. People said that they were happy with the care provided and that staff “definitely” and “absolutely” respected their privacy and dignity.

We found that people’s needs had been assessed to ensure the care they received was safe and effective.

The agency had procedures in place to ensure that people were safeguarded against the risk of abuse and staff had been provided with appropriate training.

We found that the agency had an infection control policy to promote good infection control practice. Staff showed a good understanding of infection control processes. For example, a staff member said, “We always wear gloves and aprons when providing personal care.”

We found that the agency had effective recruitment procedures to ensure appropriate checks were undertaken before staff commenced work. Staff were appropriately supported to enable them to deliver safe and effective care to people who use the service.

We found that the agency had a system in place to assess and monitor the care provided to people. This ensured people were listened to, acted on and concerns addressed in a timely manner.

Inspection carried out on 29 August 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an expert by experience who has personal experience of using or caring for someone who uses this type of service.

We used postal surveys, telephone interviews and home visits to people who use the service and to their main carers (a relative or friends) to gain views about the service.

During this review we spoke with 18 of the 180 people receiving care. We visited four people in their own homes and spoke to 14 people over the telephone.

During our visit to the people receiving care and support in their own homes on 07 August 2012 every one told us that the staff treated them well and were respectful when providing care.

People told us that they felt involved in their care and knew what to expect. They told us that they felt they had the opportunity to get to know their care worker and feel confident with them. We were also told that people were provided with information by Westminster Homecare that told them about their care provision and what to expect.

All of the people who were spoken with by telephone confirmed that their privacy and dignity was respected by the care workers. We were told us that the care workers had asked them how they wished to be addressed and we saw that this had been recorded in their files.

During our visit to people’s homes and by speaking with people via the telephone we confirmed that people were satisfied with the standard of care they received. We were told that the staff could be very flexible with the care they provided and with prior arrangement they could take their relative out and alter the times of calls.

During our conversations with people who received care from staff who worked for Westminster Homecare they told us that they felt safe and the staff were respectful of them and of their property. They told us that the staff were good and they did not identify any gaps in their ability to provide the necessary care. We were told that on the whole people had the same main care worker.

Inspection carried out on 7 February 2012

During a routine inspection

As part of this review we visited nine people who received care and support from Westminster Homecare Limited (Luton).

During our visits on 07 and 08 February 2012 we had the opportunity to view their care files and speak with them and / or their families.

Everyone said they were happy with the support they received and that they felt safe and trusted the staff from agency that supported them. They told us they were always treated respectfully by staff, who also showed respect for their home and property when they visited.

They had confidence in the staff that supported them, and said that they were helpful and friendly, and appeared confident and competent in their role.

Most people confirmed that staff from the office would contact them from time to time with regards to their satisfaction of the service they received. People told us that they felt their opinions were always listened to, and that the Manager always took swift action to address any concerns they may have immediately.