14 November 2018
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 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.
Our inspection site visit took place on 28 August and 29 August 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit so that the management team would be available.
Our inspection was completed by three adult social care inspectors and two experts-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our inspectors completed the office visit, interviewed management and staff and observed personal care provided in people’s homes. Our experts-by-experience completed telephone calls to people and relatives.
Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public, local authorities and clinical commissioning groups (CCGs). We checked records held by Companies House and the Information Commissioner’s Office (ICO).
We did not ask the service to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. The service had a prior PIR prepared, and we used information from this to inform of our inspection process.
We spoke with twenty people who used the service and five relatives. We also spoke with the registered manager, operations manager, operations support manager, deputy manager and recruiter. We spoke with five care workers and two field care supervisors. We visited six people in their homes and observed care practises. We reviewed parts of 20 people’s care records, five personnel files, medicines administration records and other records about the management of the service.
After our inspection, we asked the registered manager to send us further documents and we received and reviewed this information. This evidence was included as part of our inspection.
14 November 2018
Our inspection took place on 28 and 29 August 2018 and was announced.
This was our first inspection of the location since a change in the service’s office address. We last inspected the service in 2014 under our prior inspection methodology .
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older and younger adults, people with physical disabilities sensory impairments, learning disabilities or dementia.
Westminster Homecare Limited (Buckinghamshire) is part of a corporate provider of care at home services, with 21 registered locations. At the time of our inspection, more than 140 people used the service and there were more than 50 staff.
The provider is required to have a registered manager as part of their conditions of registration. 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. At the time of our inspection, there was a manager registered with us.
People were protected from abuse and neglect. Appropriate systems were in place to safeguard people from the risk of preventable harm. People’s care risks were appropriately assessed, mitigated and recorded. Recruitment practices and supporting documentation met the requirements set by the regulations. We found appropriate numbers of staff were deployed to meet people’s needs. People’s medicines were safely managed.
The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted 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.
Staff induction, training, supervision and performance appraisals were robust and ensured workers had the necessary knowledge and skills to effectively support people. People’s care preferences, likes and dislikes were assessed, recorded and respected. We found there was collaborative working with other community healthcare professionals. People were supported to maintain a healthy lifestyle.
The service was extremely caring. There was consistently complimentary feedback from people who used the service and relatives. Staff often went beyond their usual role to ensure people were safe, well-cared for and treated holistically. The service prevented social isolation of people who lacked contact with their local community. People told us they could participate in care planning and reviews. People also told us they were consistently encouraged by staff to make decisions for themselves, and only assisted when needed. People’s privacy and dignity was respected when care was provided to them.
Care plans were appropriate and contained information on how to support people in the best possible way. We saw there was a complaints system in place which included the ability for people to contact any office-based staff member or the management team. Concerns and complaints were recorded and reviewed to ensure positive outcomes. Questionnaires were used to determine people’s satisfaction with the care.
People, relatives and stakeholders had overwhelmingly positive opinions about the care, staff, management and leadership of the service. There was an excellent workplace culture and we saw the staff worked cohesively to ensure good care for people. Robust, frequent and extensive audits and checks were used to gauge the safety and quality of care. Where necessary, improvements were made to continuously make the service better. The service offered their support to the group of locations operated by the provider. The provider had a detailed knowledge of the service’s core operations and performance.