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Inspection carried out on 26 March 2018

During a routine inspection

Woodfield 24 is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older and younger adults as they approach the end of their life. Care and support is co-ordinated from the services office, which is based at St Catherine’s House in Balby. At the time of our inspection there were 20 people receiving care and support from the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Woodfield 24 Care Services’ on our website at www.cqc.org.uk’

Since the last inspection a registered manager had been appointed. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the registered provider.

All the people we spoke with were extremely happy with the quality of the care the service provided. Staff spoke with passion and commitment about how they cared for people and supported their family members. People’s privacy was respected and they were treated with dignity, kindness and compassion. People were supported to maintain relationships with people who were important to them.

There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. Incidents and accidents were monitored and action was taken to reduce risks to people.

People were encouraged to manage their own medication if they were able to, while other people were supported by their close family. When assistance was required appropriate support was provided by staff who had been trained to carry out this role.

Recruitment processes were robust, which helped the employer make safer recruitment decisions when employing new staff. Staff had undertaken a range of training and support that aimed to meet people’s needs while developing staffs’ knowledge and skills.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s needs had been assessed before their care package started and where possible they or their relatives had been involved in formulating their care plans. Staff worked closely with other healthcare professionals to ensure people received a seamless service that met all their needs.

The people we spoke with told us they knew how to raise any concerns and said they felt comfortable doing so. When concerns had been raised we saw the correct procedure had been used to record, investigate and resolve them.

People were consulted about their satisfaction in the service received and systems were in place to make sure company policies were followed. All the people we spoke with, including staff, told us they were very happy with the way the service was run. People spoke positively about the registered manager and how staff delivered care.

Further information is in the detailed findings below

Inspection carried out on 1 March 2016

During a routine inspection

The inspection took place on 1 March 2016 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was registered with the Care Quality Commission in March 2015, but did not start providing services until May 2015. This was the first inspection of the service.

The agency’s main aim is to provide personal care to people in their own homes as they approach the end of their lives. Care and support is co-ordinated from the services office, which is based at St Catherine’s House in Balby.

The service did not have a registered manager in post at the time of our inspection. However, an acting manager had been appointed to oversee the day to day operation of the service until a new manager could be appointed. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

At the time of our inspection there were approximately 14 people receiving care and support from the agency. Due to the nature of the service provided we could not consult directly with people who used the service due to their poor health. However, we spoke with seven relatives whose family members were using the agency at the time of our inspection, or had used it in the past. We also sampled feedback forms and telephone consultations received by the provider.

All the people we spoke with told us they were extremely happy with the service provided. They praised the management staff for the swiftness that care packages were arranged, and the care workers for the diligent and caring support they provided. One person told us, “This kind of end of life care should be available to everyone when needed. It enabled us to be his wife, children and grandchildren rather than his carers. They gave such good care I can’t praise them enough.” Another person commented, “They [care workers] were very, very good when he [the person using the service] was really poorly. They put a lot of extra time into looking after him. They phoned the doctor and kept us informed. They really went above and beyond their duties.”

We found both the management team and the care workers had a clear understanding of the importance to ensure people were treated with dignity and respect, and were able to put this into practice when supporting people.

The provider had effective systems in place to ensure people’s safety. This included staff’s knowledge and training in relation to safeguarding people from abuse, and assessing any risks people may be vulnerable to, or any that they may present. We found medicines were handled safely by staff who had received suitable training.

Recruitment procedures at the agency had been designed to ensure that people were kept safe. Staff had received an in-depth, structured induction and essential training at the beginning of their employment. This was to be followed by regular refresher training to update their knowledge and skills. Staff had received regular support sessions and there was also a system in place for staff to receive an annual appraisal of their work performance. Staff told us they felt well supported.

We found the service employed sufficient staff to meet people’s needs and were actively recruiting more staff to cover for staff absences and allow for the expansion of the agency. Staff spoke passionately about wanting to provide a high level of care and support to people, as well as supporting their families.

People’s needs had been assessed before their care package commenced and the relatives we spoke with told us they, and their family member had been involved in formulating and updating care plans. Care records we sampled identified people’s needs, as well as any risks associated with their care. We found staff were knowledgeable about the needs and preferences of the people they were supporting, but care plans did not always give clear guidance to staff about how each person preferred their care to be delivered.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected. This includes balancing autonomy and protection in relation to consent or refusal of care or treatment.

The company had a complaints policy which was provided to each person at the start of their care package. We saw a system was in place to record the details and outcomes of concerns raised. Where concerns had been raised these had been investigated and addressed appropriately.

People had been consulted about their satisfaction in the service they received. Care workers spoke positively about the management team and the way in which they led the service. They told us they were supportive and listened to their suggestions and ideas about how to improve the service. A range of audits were in place to monitor the quality of the service provided. However, some aspects of the system had not been fully embedded.