Background to this inspection
Updated
29 April 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 inspection took place on 18 March 2015. We gave the service 48 hours’ notice of our intention to inspect. The inspection team consisted of two inspectors. Before and after our inspection we spoke with people who used the service and their relatives.
Before the visit we looked at previous inspection reports and notifications we had received. Services tell us about important events relating to the care they provide using a notification. This enabled us to ensure we were addressing potential areas of concern. We spoke with local authority safeguarding and contracts teams and sought the views of one healthcare professional.
We spoke with 7 of the 53 people who were receiving care and support from Westminster Homecare Limited (Oxford). We also spoke with five people’s relatives. We received feedback from a further three people through questionnaires.
We spoke with a senior care coordinator, four care workers, the provider and a manager based at the provider's Chippenham office.
We looked at 12 people’s care records including their medicine records and at a range of records about how the service was managed. We reviewed feedback from people who had used the service and a range of other audits.
Updated
29 April 2015
We inspected Celtic Care Services Limited (Swindon and West Wilts) on 18 March 2015. Celtic Care Services Limited (Swindon and West Wilts) is a domiciliary care service which provides care and support for people who live in their own homes. At the time of our visit 53 people were receiving personal care from the service.
This was the first inspection carried out by the Care Quality Commission at this location.
There was not a registered manager in post at the service. It is a condition of the services registration that a registered manager is 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.
The service did not always have effective systems to monitor and improve the quality of service people received. People's views were sought, however these views were not always acted upon. Where senior care staff had implemented action plans around care staff performance, these actions were not always followed.
People's care plans were not always personalised and did not provide information on people's preferences. Where risks had been identified around people’s care, guidance was not always provided to care staff to support people safely.
People benefitted from positive relationships with care staff. Care staff knew the people they cared for, including their hobbies and preferences. Where people made decisions around their care these views were respected.
People were supported with their nutritional needs and received support to take their medicines as prescribed. Care staff supported people to maintain their relationships and attend healthcare appointments where appropriate.
Care staff were supported to develop professionally and have regular supervision (one to one meetings with their line managers). Care staff had the training they needed to meet people's needs, which included specialist training where required.
Care staff had an understanding of consent, and people told us they were always asked for their permission by care staff. Care staff had received training around the Mental Capacity Act 2005 (the MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time).
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.