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Wandle Healthcare Services Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 March 2018

Morden is a domiciliary care agency. This service provides personal care to people living in their own houses and flats. It provides a service to older adults, some of whom have dementia, physical disabilities and mental health needs. At the time of inspection 111 people were receiving support from this service.

This inspection was carried out on 6 February 2018 and was announced. We gave the registered manager 48 hours’ notice of the inspection because we needed to be sure that someone would be in when we come to inspect the service.

At the last inspection on 19 November 2015 the service was rated GOOD. At this inspection we rated the service Requires Improvement, with Requires Improvement in effective and responsive.

The service had a registered manager 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.

We found that people’s care plans were not always accurately maintained. Information was missing on some of the needs identified and there were no records available on the support people required to meet these needs.

The training provided for staff was not always effective. Staff received a number of training courses in one day which made it difficult to retain information.

The management team had monitored safeguarding alerts raised and took actions to protect people as necessary. There were risk management plans in place to mitigate known risks to people. Recruitment checks were carried out to assess staff’s suitability for the role. The management team ensured that people had support to take their medicines in line with the service’s procedures. Measures were put in place to control infection and prevent accidents occurring.

Electronic systems were used to monitor the time staff spent with the people they were supporting. Staff also used their phones to share information as quickly as possible. Staff received one-to-one time with the managers to discuss their developmental needs and any concerns they had. People had the same staff members to support them which meant that staff knew people’s care and support needs well. Staff assisted people with their food shopping and cooking meals as necessary. There were processes in place for staff to follow to support people to make their own decisions if there were any concerns in relation to their capacity.

People and their relatives consistently told us that staff were caring, kind and respectful towards their privacy. Staff ensured that people had their dignity maintained and provided personal care in a way that felt comfortable. People had support to go out in the community and to maintain relationships that were important to them. People’s independence was enhanced and staff encouraged people to carry out tasks for themselves if they were able to. Staff knew what was important for people and ensured they provided people with the assistance they required.

People’s care and support needs were monitored and reviewed regularly so staff could provide the required level of care for people. People and their relatives approached the management team for information or if they were not happy about something so improvements could be made as necessary. Systems were in place to gather people’s feedback about the support they received and if they wanted to make any changed to the service delivery.

There was good leadership at the service and the staff team shared responsibilities to ensure effective care for people. Staff were provided with the service’s policies and procedures to follow and to provide consistent care for people. Quality assurance systems were in place and regular audits took place to review the quality of the care being delivered to people. The service worked in partnership with relevant agencies to share information about peoples changing needs.

We found two breaches of the regulations in relation to staffing and safe care and treatment. You can see what action we have told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Good

Updated 29 March 2018

The service was safe. The safeguarding alerts raised were monitored and acted upon as necessary. Risk assessments were in place and followed by staff to support people safely.

People had support to take their medicines as prescribed.

There were safe procedures in place for recruiting staff, preventing infection and reporting incidents and accidents.

Effective

Requires improvement

Updated 29 March 2018

The service was not always effective. Staff had not received sufficient training to meet their role expectations.

Electronic systems were used to ensure that staff attended their shifts as necessary. Staff had support to review their developmental needs.

People were assisted to meet their nutritional needs.

Processes were in place to support people under the Mental Capacity Act (2005).

Caring

Good

Updated 29 March 2018

The service was caring. Staff were respectful and supported people to maintain their dignity as necessary. Staff were aware of people’s preferences and used this information to support people the way they wanted to.

People had assistance to maintain social contacts if they wanted to.

People’s independence was enhanced and they were enabled to carry out tasks for themselves where possible.

Responsive

Requires improvement

Updated 29 March 2018

The service was not always responsive. People’s care plans lacked information on people’s care and support needs.

People had support to review their care plans regularly.

People approached the staff team if they wanted to make changes to the service delivery.

Well-led

Good

Updated 29 March 2018

The service was well-led. There was a clear management structure in place to ensure effective running of the service. Responsibilities were shared within the management team to review care delivery as necessary.

Staff followed the service’s policies and procedures to support people’s well-being.

The service worked in partnership with relevant agencies to ensure they delivered person centred care to people.