Background to this inspection
Updated
17 February 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection.
The inspection took place on 22 and 23 January 2018 and was unannounced.
The inspection was conducted by two adult social care inspectors.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We checked the information that we held about the service and the service provider. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law.
As part of our planning for this inspection we sent out questionnaires to people connected with WarrenCare. We received eight out of 50 questionnaires back from people using the service, 55 out of 250 from staff, zero out of 50 from relatives and zero out two from community professionals. We used all of the information available to us to plan how the inspection should be conducted.
During the inspection we spoke with six people using WarrenCare’s services, four of their relatives, ten care staff, the registered manager and senior managers responsible for oversight of the service. We also spent time looking at records, including 15 people’s care records, ten staff files, medication administration record (MAR) sheets, staff training plans, complaints and other records relating to the management of the service.
Updated
17 February 2018
WarrenCare is a large domiciliary care agency that provides support to children and adults with disabilities and complex needs in their own homes and communities. At the time of the inspection 580 people were receiving care and support. An additional ten people were provided with 24 hour support in five supported living services.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated Good.
The service met all relevant fundamental standards.
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.
People and their relatives told us that the service was safe. The service maintained effective systems to safeguard people from abuse. Staff were aware of what to look out for and how to report any concerns.
Staff were safely recruited and deployed in sufficient numbers to provide safe, consistent care and support. The employment records for staff were maintained to a high level and showed clear evidence of employment histories, references and checks.
The majority of medicines were safely stored and administered in accordance with best-practice. Staff were trained in administration. However, we did see examples where this was not the case. The registered manager had already identified a training need in relation to medicines’ errors and had organised additional training. There was no evidence that any errors had been significant or had resulted in harm being caused.
Procedures in place reduced the risk of infection. Staff were clear about the need to use personal protective equipment when providing personal care.
People’s needs were assessed in sufficient detail to inform the delivery of care. Care and support were delivered in line with current legislation and best-practice.
The service ensured that staff were trained to a high standard in appropriate subjects. This training was subject to regular review to ensure that staff were equipped to provide effective care and support.
People were supported to eat and drink in accordance with their needs. We saw evidence that staff worked with relatives to ensure that people had access to nutritious meals that met their preferences.
People told us that staff treated them with kindness and respect and we saw this when we visited people receiving care. It was clear that staff knew people, their needs and preferences well and provided care accordingly. We saw staff talking to people in a gentle, knowledgeable and supportive manner about their care needs, families and other things of interest.
People were actively involved in decisions about their care. Staff took time to explain important information and offer choices. This was achieved by talking face to face and making use of different forms of communication where required.
It was clear from care records and discussions with people that their care needs were met in a personalised way. Each person had different preferences and goals that were reflected in their care records.
The majority of people that used the service had specific needs in relation to equality and diversity. We saw that people’s needs were considered as part of the planning process in relation to; disability, age and religion as well as other protected characteristics.
We checked the records in relation to concerns and complaints. There were 26 complaints recorded in 2017. Each had been addressed in accordance with the provider’s policy and included a detailed, written response.
The majority of people spoke positively about the management of the service and the approachability of senior staff. However, there were a small number of concerns raised about the quality and timeliness of communication by some people using the service and staff. We raised this matter with the registered manager who had already recognised an issue and taken measures to improve practice.
WarrenCare had a robust performance framework which helped to clearly define roles and responsibilities. A substantial and regularly updated set of policies and procedures provided guidance to staff regarding expectations and performance. We saw clear evidence that staff had been challenged when their performance did not meet the required standards.
The service had used safety and quality audits to identify and address issues relating to; staff conduct, medication errors and missed calls. Information had been used effectively to improve practice and to inform further development.
Further information is in the detailed findings below.