Background to this inspection
Updated
12 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was conducted by two inspectors, an Expert by Experience and an interpreter. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period of notice for the inspection because we needed to give people the opportunity to meet with the inspector in their own homes.
Inspection activity was completed on 9 September 2019. We visited the office location on 9 September 2019.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff including the nominated individual, registered manager, service development manager and two care workers.
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
12 October 2019
About the service
Chinese Wellbeing is a domiciliary care service providing personal care to people living in their own homes. At the time of the inspection 29 people were receiving care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People spoke extremely positively about the service and the outcomes it helped them to achieve. Chinese Wellbeing worked creatively with other agencies to provide care which had a positive impact on people’s health and wellbeing. When people were unwell staff acted promptly to ensure they received appropriate care and treatment. Staff were deployed flexibly to ensure people had the support they needed to make the best use of healthcare services. People were supported to maintain a healthy diet in accordance with their individual needs and preferences. Staff were given an induction in accordance with recognised standards for care staff. Staff were also given regular additional training to improve their skills and knowledge. The service worked in accordance with the principles of the Mental Capacity Act 2005 (MCA).
There was a strong, natural person-centred culture which was evident in our observations and the actions and comments of all staff. Chinese Wellbeing was primarily commissioned to provide personal care. However, we saw numerous examples of staff supporting people to engage in meaningful and culturally appropriate activities which helped people avoid social isolation. The service made very effective use of fundraising and partner organisations to maximise people’s opportunities to access activities. People’s individual needs and preferences were consistently considered as part of the care planning process. This included supporting the needs of people living with dementia and their relatives. Care and communication methods were sensitively adapted to promote people’s independence and choice. People were encouraged and supported to take the lead in assessment and care planning processes with the support of an interpreter. People and their relatives spoke very positively about the caring nature of staff.
The comments and behaviours of the registered manager and other senior staff consistently reflected their commitment to a genuinely person-centred, user-led service. It was clear this had resulted in positive outcomes for people. People using the service and staff spoke about how they or their relatives led discussions about care needs. This was done naturally in response to people’s needs, rights and cultural expectations. Managers and staff regularly provided additional services to ensure people’s needs were met by working holistically and in partnership with other organisations. The service offered their expertise for the benefit of the wider BAME (Black and Minority Ethnic) community and worked effectively with the local authority and community groups to maximise the impact of their work. Chinese Wellbeing was exceptional at engaging people using the service, their relatives and staff. The service operated as an extension of the family unit and built relationships on trust. Chinese Wellbeing had a proven track record of securing additional resources and developing productive partnerships with other organisations. Following the last inspection additional partnerships had been developed with other services in the area to further improve outcomes for people. The service placed continuous learning and improvement at the heart of their practice. They made effective use of audits, reports and other forms of communication to monitor and improve the safety and quality of care.
People and their relatives spoke very positively about the caring nature of staff. They told us they were always treated well by staff and were consulted about their care. There was a strong, natural person-centred culture which was evident in our observations and the actions and comments of all staff. Every interaction between staff and people receiving care we witnessed was kind, positive and exceptionally respectful. Staff were well-matched and aware of the wide range of cultures within the Chinese community. People were encouraged to comment on the provision of care and were actively involved in the decision-making process through discussions with staff and regular meetings. Important information was translated by the service and made available in different formats. Staff supported people with their personal care needs in a discreet and sensitive manner. Staff told us how important this was to people and explained how they supported people’s right to privacy at all times.
People were well protected from the risk of abuse or neglect and told us the service helped them to feel safe. Systems and processes were in place to reduce the risk of harm. Risk was assessed as part of the management of the service and effective measures had been taken to reduce risk and maintain people’s independence. Safe recruitment practices were used to ensure new staff were suited to working with vulnerable people and understood the Chinese culture. Appropriate checks were completed before new staff started work. Staff were deployed in sufficient numbers to meet people’s needs and provide safe care from a consistent team. Medicines were well-managed and people were supported to administer their own medicines with minimal prompting. Staff understood the need for effective hygiene standards to reduce the risk of infection. Staff recorded incidents and accidents in sufficient detail to aid analysis and reduce risk.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Outstanding (published 17 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.