Chinese Wellbeing / Merseyside Chinese Community Development Association

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.

The Chinese Wellbeing service were providing care for 27 service users who were all from a Chinese culture, speaking Chinese/Cantonese as their first language at the time of our inspection. They had a complement of 24 staff who spoke Chinese as their first language who were providing care in people’s homes in addition to office staff who consisted of the Chief Executive (CEO), service development manager, registered manager, two senior carers, one care manager, a dementia support champion and an administrator.

There was a registered manager in post at the time of our inspection. 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.

Within the domiciliary care service being offered, people had access to advocacy services, a luncheon club, a personal wellbeing service, a transitional service, mental health and wellbeing service and dementia services such as ‘The Tea House Reminiscence’.

The most striking aspect of this dynamic service was the strong sense of leadership, commitment and drive to deliver a service which improves the lives of people in a fulfilling and creative way. There was effective leadership at differing levels within the service from the top down. The culture was embedded to deliver a service by the Chinese cultural code which was regarded as the “five hearts” which were attentiveness, care, love, endurance and patience.

Staff told us they received supervision on a monthly basis and they received annual appraisals. Staff were well respected within the organisation by senior managers and were being provided with comprehensive training including specialist training. There was a culture of striving for excellence including for staff to reach their maximum potential by achieving in their roles through attending specialist training in areas such as advocacy. The service was making a difference to people’s wellbeing by working well as a team, in harmony with one another sharing the same values and principles. There was a strong caring culture with clear leadership in exploring new innovative ways of providing care in a person centred way.

People were being cared for with a level of support which was above and beyond providing support with task based activities such as washing and dressing. People were receiving a case management model of care which involved the case manager referring people on to the most appropriate services or healthcare professionals with the person’s consent.

The service were being proactive in providing people with a range of information to assist them to make decisions about their health and wellbeing. We found examples were staff had worked with health and social care professionals for the benefit of the person receiving care and were actively contributing to supporting people to attend their health appointments, recording clearly in the records the advice provided by the health care professional in order to support the person to follow the advice given.

People were listened to and their voice was heard in a variety of creative ways such as by people taking part in surveys, reviews, taking part in short films and publications such as the service’s own newsletter. Staff supported people to make decisions for themselves and spoke with people about their wishes and preferences whilst delivering care.

Staff wanted to know if they could improve anything for people and wanted to deliver care which was person centred. Staff were observant and reported health/behaviour changes and were flexible in adapting the way they provided care ensuring they were person centred.

The service actively participated in wider projects and kept up to date with what was going on within the health sector and social care sectors. They were committed to developing a service tailored to meet the specific needs of people; in particular their empathy towards people who were living with dementia was displayed by their efforts and hard work involved in developing a dementia service for people. The staff demonstrated a passion to set up a Tea House Reminiscence session for people who were receiving care and to also access a group which involved people within the Chinese community who were living with dementia coming together as a group.

The benefits of this service were illustrated within a short film which the service compiled to raise awareness. They had arranged for memorabilia to be shipped across from China such as Chinese tea cups, tea pot, books and other items to replicate as much as possible what people would have been used to when living in China. In the short film, people were seen laughing, conversing and reading all through the medium of the Chinese language whilst enjoying a drink of Chinese tea. This was contributing to people’s mental health wellbeing and providing social interaction which was meaningful and person centred.

We found staff had an understanding of safeguarding and were aware of what to do if they wished to whistle blow. The service provided people who use the service with information in their own language about the different types of abuse and who to contact if they needed support. The registered manager was aware of risks within the service and was undertaking analyses of risks. The service had emergency plans in place and took action when they became aware someone was at risk.

People’s care needs were risk assessed with risk management plans in place and support for staff when they needed it. Recruitment checks were carried out and there were a high number of staff who worked within the service who were long term staff within the organisation, providing consistency for people receiving care.

Staff were confident within medication management and were skilled to identify side effects and report them to the General Practitioner. People were supported to seek medical advice and health care professionals input.

Carers prepared freshly cooked food which was important for people who as part of their culture were unable to eat fast food or ready prepared meals which needed warming up.

The service were acting as advisors in some cases for health and social care professionals in trying to meet the needs of people with mental health and physical disabilities who are from a Chinese culture.