Background to this inspection
Updated
10 January 2017
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 was 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 09 November 2016. The provider was given 48 hours’ notice. We did this to ensure the provider was available to meet with us and provide access to records. The inspection team consisted of one inspector with experience of inspecting domiciliary care services.
Before the inspection we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the registered person is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection. We also asked the provider to complete a Provider Information Return (PIR) before our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
Along with the PIR, the provider sent us a contact list of people who used the service, their relatives, staff employed and other professionals involved with the agency. Using this information we sent out questionnaires to a range of people. We received responses from seven people, two relatives and eight staff. The feedback gathered from these questionnaires has been used to help inform the judgements made in this report.
During our inspection we went to the agency’s office and spoke with the provider and five members of staff. After the inspection we conducted telephone interviews with four people that used the service, one relative and two professionals who have had recent involvement with the service. We reviewed a variety of documents which included five people’s care plans, three staff files and other records relating to the management of the service.
Updated
10 January 2017
Waverley Community Care is a domiciliary care agency which provides care to people living in their homes. The agency provides a range of services, but at the time of this inspection it was primarily to older people with physical health needs and adults who required mental health support. The agency is registered to provide both personal and nursing care, but was not providing the latter at the time of our visit. At the time of our inspection 19 people were receiving a personal care service from the agency.
The inspection took place on 09 November 2016 which included a visit to the service’s office on that date. Calls to people, their relatives and other professionals were made after the visit.
The agency had a registered manager. 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 previously carried out an unannounced comprehensive inspection of this service on 05 October 2015. At that inspection seven breaches of legal requirements were found in respect of good governance, recruitment, safeguarding, record keeping, planning and reviewing care and the management of medicines and risks. As a result the service was rated Requires Improvement and a Warning Notice and six requirement actions for the service to improve were set. Following that inspection, the provider sent us an action plan which identified the steps they intended to take to make the required improvements. We have been in regular contact with the provider since the last inspection who had updated us about the changes they had made. This inspection found that the provider had taken the action they told us they had in respect of each of these areas and as such each requirement action had been met.
The service now had a stronger leadership team which worked collaboratively together to deliver effective care. The collective professional qualifications of the management team enabled people’s specialist needs to be met by staff who were well trained and supported.
People received support from a regular team of care workers who knew and understood their needs. People appreciated consistent support from the same staff with whom they had built a rapport and trusted.
The service had improved its systems for recruiting new staff and now took appropriate steps to ensure that staff were properly checked and vetted prior to being employed. Once employed, staff completed a comprehensive programme of induction and training to ensure they had the necessary skills and experience to meet people’s needs.
People’s needs and homes were fully assessed before care was provided. As such, any risks associated with their care were now identified and managed safely. The service had appropriate systems to safeguard people from the risk of harm or abuse and staff were knowledgeable about how to keep protect people and keep them safe.
The service was responsive to changes in people’s needs and tailored their services accordingly. People were involved in the planning and reviewing of their care and supported to be as independent as possible. Staff respected people and understood the importance of gaining consent from people. Staff demonstrated an awareness of the Mental Capacity Act 2005 and knew what to do if a person refused to accept their care.
Staff were kind and compassionate and demonstrated the values of the agency to provide caring support. As such, people received care that was provided in a respectful way that promoted their privacy and dignity. The agency created social opportunities for those people at risk of loneliness and isolation.
People were supported to maintain good health. The service worked in partnership with a range of other healthcare professionals to provide a holistic approach to care. Where people were supported with their medicines, this was done safely.
Staff understood the importance of supporting people to maintain adequate nutrition and hydration. Care plans identified where people needed additional support and steps were taken to ensure these people received sufficient food and fluids each day.
Waverley Community Care now had appropriate systems in place to monitor and improve the quality of its services. People were regularly asked for their feedback and satisfaction surveys sent to people, staff and professionals were used to identify areas for on-going improvement.
The quality of record keeping across the service had improved which enabled the provider to demonstrate the care provided to people.