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Walthamstow Employment & Nursing Agency Limited Good

Reports


Inspection carried out on 27 October 2017

During a routine inspection

This inspection took place on 27 and 30 October 2017 and was announced. The provider was given 24 hours’ notice because the location provides a personal care and nursing care service to people in their own homes and we needed to be sure someone would be in. One inspector carried out this inspection. At the time of this inspection there were eighty people using the service.

At the last inspection, on 28 and 30 December 2016, the service was rated Good overall and we found one breach of the regulations. This was because although the provider had systems to audit the quality of the service provider, they did not always document the outcome of these checks. At this inspection we found improvements had been made in this area. The provider now documented the outcome of quality audit checks.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manager 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.

Staff were knowledgeable about safeguarding and whistleblowing procedures when they suspected abuse. The service used an electronic system to monitor if staff were late or missed a visit. Safe recruitment checks were carried out. People had risk assessments done to ensure safe care was provided and potential risks were mitigated. There were systems in place to ensure people were supported to manage their medicines safely. Staff were supplied with sufficient quantities of personal protective equipment to prevent the spread of infections.

The registered manager and staff were knowledgeable about their responsibilities around the Mental Capacity Act (2005) and the need to obtain consent from people. Staff received support with training opportunities. Support was given to staff through formal supervisions in accordance with the provider’s policy but staff told us they would benefit from more frequent supervisions. The registered manager told us they offered informal supervisions to staff but these were not documented. Staff were aware of people’s nutritional and hydration needs. The provider liaised with relevant healthcare professionals and supported people to maintain their health.

People and relatives thought staff were caring and respected their privacy and dignity. Staff were knowledgeable about people’s care needs and preferences. Staff demonstrated awareness of equality and diversity, promoting people’s dignity and maintaining independence.

Care plans were personalised and contained people’s histories and preferences. Staff demonstrated awareness of providing personalised care. Complaints were dealt with appropriately and in line with the provider’s policy.

The provider has systems in place to obtain feedback from people who used the service and their relatives. People who used the service, relatives and staff spoke positively about the management of the service. Staff had regular meetings to keep them updated on service development.

We have made one recommendation around supporting staff. Further information around this can be found in the detailed findings below.

Inspection carried out on 28 December 2016

During a routine inspection

Walthamstow Employment & Nursing Agency provides personal care for people in their own homes, some of whom may be living with dementia. We inspected the service on 28 and 30 December 2016 and at the time of this inspection 130 people were using the service.

There was a registered manager at the service. 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.

At the last inspection on 20 September 2013, the service was found to be meeting the legal requirements. At this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.

The provider checked the quality of the service provided but was inconsistent in documenting the outcomes of these checks. People and their relatives were asked for their views about the service. Staff had regular staff meetings to receive updates on the service.

The service had safeguarding and whistleblowing policies in place and staff knew what action to take if they suspected someone was being abused. Safe recruitment checks were carried out. People had risk assessments done to ensure safe care was provided and potential risks were minimised. There were systems in place to ensure people were supported to manage their medicines safely.

Staff were supported with regular training opportunities and supervisions. The registered manager and staff were knowledgeable about their responsibilities around the Mental Capacity Act (2005) and when they needed to obtain consent from people. Staff were aware of people’s nutritional and hydration needs.

People and relatives thought staff were caring and respected their dignity. Staff were aware of people’s needs and preferences. Staff demonstrated their awareness of how to provide dignified care, and encourage people’s independence.

Care plans were personalised and staff demonstrated awareness of providing personalised care. Complaints were dealt with appropriately and in accordance with the provider’s policy. The provider also kept records of compliments about the service.

Inspection carried out on 20 September 2013

During a routine inspection

We spoke to 15 people who used the service three relatives and a palliative care nurse. People told us that the care was good and that they trusted the people who looked after them. They valued having the same staff for continuity of care.

At our last inspection we were concerned about training for staff in particular refresher training for medication and safeguarding had not been completed. We found that this was now being monitored effectively and relevant training had been completed and was planned for. We checked ten staff files and found them to contain appropriate recruitment checks including, right to work, proof of identity, relevant qualifications and two verified references.

We found that monitoring quality of care had improved and that there was evidence to indicate that people's views were taken into account. Complaints were dealt with in a timely manner. One person said, "any complaints are always looked into promptly." Another said, "I have seen the senior staff come and assess my carer in my home. They asked me what I thought of the care"

Inspection carried out on 19 April 2013

During a routine inspection

We spoke to 18 people who used the service, six relatives, two managers and 15 staff. We found that in most cases, people received the care that they needed. Staff told us that they asked and involved people every step of the way. One staff said, "during induction, we were taught to always ask the client what they wanted done before starting. Sometimes we have to prompt or encourage people."

We looked at eight care plans and found that they were specific to the individuals needs. It was clear how much time was spent and which staff were assigned duties. Risk assessments were available and there were procedures in place to ensure that environmental risk assessments were updated by team leaders when required.

The manager told us that staff were matched to the needs of the clients. This was confirmed by staff and the care records we reviewed. Staff were appropriately qualified for their roles.

However, there were shortfalls in the way that the provider dealt with safeguarding issues which potentially put people at risk of financial abuse. The provider’s management systems were inadequate. People who used the service said that staff often turned up late and this was due to the way that the rotas had been organised. Complaints were not always resolved satisfactorily and acted upon and this did not lead to improvements in the service being provided

Inspection carried out on 4 May 2012

During a routine inspection

People who used the service told us that they were happy with the service and that they were involved in decisions about their care. Most of the people who used the service said they had a positive experience. A person we spoke to told us that the service was “reliable, good and maintains privacy”. Another person said he was able to tell the carers what he wanted. He said the carers listened to him and met his needs. People expressed their views and were involved in making decisions about their care and treatment. Many people said that they were asked for feedback on the service.

People who used the service told us that the service was flexible. For example: if they had appointments with other specialist services the service would adjust their visit times in order to allow people who used the service to attend. People we spoke to had trust and confidence in the staff that looked after them. One person who used the service said the staff were “polite and understanding”.