Archived: North West Wiltshire - Kennet and Mendip

North West Wiltshire - Kennet and Mendip provides personal care and support to people in their own home.

A registered manager was in post. 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.

Risk management systems were not always effective. Members of staff we spoke with described the measures in place to minimise risk. However, not all risks were assessed. Risks were not assessed for people with medical conditions which require well balanced meals and for people with poor appetite. Along with the risk assessments the person’s capacity to make decisions about their eating and drinking were not undertaken. Risk management systems were to be improved for people with high dependency needs.

Quality assurance systems were to be developed to incorporate better monitoring of people at higher risk. Systems were audited to ensure the standards of care were met and to identity patterns and trends. The views of people and their relatives about the agency were gathered and acted upon.

People with capacity to make decisions gave their consent for staff to deliver care and treatment. Where there were lasting power of attorney’s appointed they also signed consent forms for care and treatment.

People told us they felt safe when staff were present. The staff we spoke with were able to describe the procedures for safeguarding vulnerable people from abuse. They knew the types of abuse and the expectations placed on them to report abuse.

Recruitment procedures ensured the staff employed were suitable to work with vulnerable adults. New staff received an induction to prepare them for the role they were employed to perform. Training courses were available monthly for staff to attend. Staff told us the agency training programme was good and they were able to meet people’s specific needs. Training records evidenced the staff attended mandatory training set by the provider and other specific training such as dementia awareness and vocational qualifications.

The agency was fully staffed and offered continuity of care to people. People had their personal care delivered from the same regular staff which meant people received care that was consistent. People told us staff mostly arrived on time and stayed the allocated visit times.

People were supported with their ongoing health. Where appropriate healthcare visits were arranged while staff were present to ensure correct guidance was delivered to the staff.

Care plans had some person centred elements but action plans lacked detail on how staff were to meet the desired outcomes detailed. Care plan templates that assisted staff with developing plans which included the person’s preferences were to be introduced.

As part of this inspection we visited four people (who use Carewatch) in their own homes. This included speaking with one relative. We spent time in the office reviewing records and spoke with five members of staff.

We found people were provided with sufficient information which enabled them to make an independent and informed decision, about the care and support they required. Staff we spoke with understood the importance of obtaining people's consent. They explained what they would do if they had any concerns about a person's ability to consent to their care and treatment.

Everyone we spoke with was complimentary of the staff and were satisfied with the care and support they received. Comments included: "I cannot fault the care and attention I receive. I have regular carers which is important to me, they know me very well and I don't have to keep explaining what needs to be done and when. They are kind and that matters to me." Another person described the regular staff they had supporting them as being "extremely caring and experienced and know me very well. Staff are very polite and respectful." A relative explained: "X is very pleased with the staff she has support her. The important thing for me is that she is happy." Another person described the care they received as "exceptionally good, they don't rush me and work at my pace. They have sufficient time to deliver what I expect and need."

We found the management of people's medicines was well organised and staff were trained effectively to carry this out safely.

We saw there were systems in place to monitor and assess the quality of its service; which showed examples of improvements they had made in response to comments from people who used the service. Everyone we spoke with agreed they had opportunities to express their views regarding the care provided, and were confident any concerns would be dealt with effectively.

We found that detailed care plans were in place to provide guidance and information for staff. This helped to ensure that staff understood the needs of the people they visited and got to know people as individuals.

People told us that they had the information that they needed about the agency and they knew what to do if they had any concerns. We found that the agency had procedures which helped to protect people from harm and reduce risks to the people who used the service and to staff.

A training programme was in place so that people received support from competent staff. Training in dementia was being given a high priority. Systems for quality assurance were well established. This meant that the provider checked on the standards being achieved and was developing the service for the benefit of the people who used the agency.