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Wandle Healthcare Services Requires improvement

We are carrying out checks at Wandle Healthcare Services. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 14 March 2019

Wandle Healthcare Services 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 are on end of life care, living with dementia and have physical disabilities. At the time of inspection 33 adults were receiving support from this service.

At the last inspection, carried out on 6 February 2018, the service was rated Requires Improvement overall, with Requires Improvement in both the key questions, ‘Is the service effective?’ and ‘Is the service responsive?’. We found two breaches of the Regulations in relation to staffing and safe care and treatment.

This inspection took place on 4 and 5 February 2019 and was announced. We contacted the service 48 hours before the inspection to let them know that we will be coming to inspect them. We wanted to make sure that the management team would be available on the day of inspection.

This was a comprehensive inspection of the service and we rated the service Requires Improvement again. Their previous rating for the key question, Is the service effective? Has improved to Good. However, the rating for the key question, Is the service responsive remained Requires Improvement. The key questions, Is the service safe? and Is the service well-led? Has deteriorated from Good to requires improvement at this inspection.

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.

Risks to people's health and safety were not sufficiently assessed to ensure that appropriate guidance was provided for staff to mitigate the potential risks to people.

Care plans had not addressed the support people required to manage their health needs and to meet their individual care needs.

The provider did not have robust systems in place to monitor the quality of the services provided for people, including accuracy of care records and reviewing of incidents and accidents and complaints.

People felt well supported by staff and safe in their care. Staff had to undertake appropriate checks before they were employed by the service. Staff followed the service’s processes to provide immediate support to people if they noticed people being at risk to harm or when incidents and accidents took place. People had support to manage their medicines safely. However, some improvement was required to ensure that the medicine administration records were maintained appropriately.

Staff accessed appropriate training that gave them the knowledge and skills to support people effectively. Staff were confident that any concerns raised

would be acted upon by the registered manager appropriately. People told us that staff arrived for their shifts mostly on time and that they were contacted if staff were running late. Staff understood and followed the principles of the Mental Capacity Act (MCA) 2005. Healthcare professionals provided guidance to staff where people required support to meet their health needs and dietary requirements.

People’s views were listened to and staff had time to have conversations with people. Staff provided support that was respectful towards people’s privacy, culture and religion. People were treated with dignity and kindness. Staff enhanced people’s independence and encouraged people to take part in the activities of their choice.

People made choices about the support they wanted to receive and how they wanted to be cared for. Staff used people’s preferred communication strategies to involve them in conversations. People’s views were gathered and dealt with in a professional manner. Staff were guided on the support people required at the end stages of their life.

People felt t

Inspection areas

Safe

Requires improvement

Updated 14 March 2019

The service has deteriorated to Requires Improvement.

Staff did not always have access to sufficient risk management plans to help them prevent the potential risks to people. Although people were supported to take their medicines safely, we found that medicine administration sheets were not always completed correctly.

Staff followed provider’s safeguarding procedures and ensured that people

were protected from potential harm and abuse.

Staff undertook pre-employment checks which protected people from being cared for by unsuitable staff.

Effective

Good

Updated 14 March 2019

The service has improved to Good. Staff received thorough mandatory training to meet people’s care and support needs safely. Supervision and appraisal meetings were carried out to help staff in their role.

Staff applied the Mental Capacity Act (2005) principles in practice to assist people to make choices as necessary. People told us that staff arrived for their shifts mostly on time.

People's dietary and healthcare needs were met by the provider where that was part of their support.

Caring

Good

Updated 14 March 2019

The service continues to be caring.

Staff interacted with people in a kind and caring manner. People told us that staff treated them with respect.

Staff supported people’s right to privacy and respected people’s dignity when they provided personal care.

Staff enhanced people's skills which helped to maintain their independence.

Responsive

Requires improvement

Updated 14 March 2019

Some aspects of the service continued to be not responsive. Care plans lacked information on the assistance people required for staff to carry out tasks safely.

Staff adhered to people’s individual support needs which ensured they provided person centred care.

There were robust complaint management systems in place to dealt with complaints appropriately. People told us they knew how to raise their concerns and felt confident they would be listened to.

Well-led

Requires improvement

Updated 14 March 2019

The service has deteriorated to Requires Improvement.

The provider did not operate effective systems to assess, monitor and improve the quality and safety of the services being provided for people.

Staff felt the registered manager was approachable and available to speak with when they needed guidance in their role.

Staff worked together to ensure good communication and information sharing at the service.