As part of our inspection we looked at care and welfare, medication, recruitment of staff, staff support and quality assurance. At our last inspection, North West Branch had been judged as non-compliant with regards to medication management (regulation 13).Our inspection team was co-ordinated and carried out by an inspector from the Care Quality Commission who helped answer our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
As part of our inspection we liaised with the registered manager and one of the designated team leaders within the area. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
We spoke with four people who used the service during our inspection who told us they felt treated with respect and dignity by staff at all times. People told us they felt safe and comfortable in the presence of staff. The service had systems in place in relation to the Mental Capacity Act with relevant training available to staff. This meant people were safeguarded as required.
People’s houses had been checked and appropriately risk assessed to meet the needs of people with physical impairments. This covered moving around the building, security, kitchen area and gas/electrics.
We found medication practices were not always safe and thorough. Although the people we spoke with told us they felt they received their medication as required, accurate records were not always maintained within MAR (Medication Administration Records) to confirm it had been administered safely. This had the potential to place people at risk as highlighted during our previous inspections in February 2013 and January 2014.
We looked at staff recruitment processes and found appropriate systems were in place. This included ensuring a minimum of two references were obtained and a DBS (Disclosure Barring Service) checks undertaken.
Is the service effective?
Initial needs assessments were conducted by care co-ordinators and team leaders and were done in conjunction with people who used the service and their families. We were able to see copies of these in people’s care plan. Specialist dietary, mobility and equipment needs had been identified in care plans where required. The care plans were looked at during our inspection were due for review and the registered manager told us this would be done following our inspection. This meant people’s care needs could be amended if required to keep people safe.
The people we spoke with told us they usually had a regular carer, but that on occasions this changed if they were unavailable and was not a problem to them. Managers ensured people’s care needs were taken into account when making decisions about the numbers, qualifications, skills and experience required for carers. This helped to ensure people’s needs were always met.
Is the service caring?
The people we spoke with felt staff were caring towards them. Comments from people included: “They meet my care requirements” and “Staff help me to shower and assist me with my meals” and “I’m treated with dignity and respect. That is one of their strengths I would say” and “The girls are brilliant I would be lost without them”.
People’s preferences, likes/dislikes and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. Risk assessments were in place and covered building security, moving and handling, trips/fall and appliances. We noted control measures were in place to keep people safe. Risk assessments were also due to be reviewed and the manager told us this would be completed following our inspection.
During our inspection we spoke with people in their own homes and we observed staff speaking with people in a caring manner and it became apparent they got along with each other very well. One person commented; “They are extremely caring”.
Is the service responsive?
There was a complaints procedure in place. People knew how to make a complaint if they were unhappy but had never been given reason to. People can therefore be assured that complaints are investigated and action is taken as necessary when required.
Systems were in place to ensure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
There were other various quality assurance systems in place. These included the sending of regular surveys, observations/spot checks of staff at work and regular supervision for carers where they were able to discuss issues affecting their work.
Is the service well-led?
The day to day running of North West Branch is done by the registered manager with support from care co-ordinators and team leaders. In addition, duties are overseen by representatives from Shaw Health Care.
The service worked well with other agencies and services to make sure people received their care in a joined up way.
We looked at the minutes from a recent staff meeting . There was an agenda in place which covered topics including training, care, the environment in people’s homes, and general staff issues. We noted staff had been able to discuss any issues or concerns affecting their work.