Wessex Regional Care Domiciliary Service

Updated 18 September 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector and an Expert 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes. The service also provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before we inspected Wessex Regional Care Domiciliary Service, we looked at the information we already held about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We looked at notifications. Notifications are sent to us by the service to tell us about significant events. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and two relatives about their experience of the care provided. We spoke with 16 members of staff including the provider, registered manager, locality manager, human resources manager, training manager, senior support workers and support workers.

We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at nine staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We received all of the additional documents we had requested including policies and procedures, audits and quality assurance questionnaires.

Updated 18 September 2019

About the service

Wessex Regional Care Domiciliary Service is a domiciliary care provider. At the time of this inspection 47 people received personal care support from the service. The service supported people who have learning disabilities, people with autism and older people either in their own homes or in supporting living accommodation.

Not everyone using the service receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a domiciliary care provider and there were also people receiving care in supported living accommodation. These were small, residential properties where people received individual support. There were no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate the houses were supported living accommodation.

People’s experience of using this service and what we found

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were supported by staff trained to identify the signs and symptoms of abuse who would not hesitate to report poor practice of colleagues.

Risk assessments were completed, and risks minimised however positive risks were promoted to enhance people’s experiences.

Staff were mainly safely recruited. Improvements were instigated to the recruitment process during our inspection. We have made a recommendation about the recruitment procedures.

Staff were trained and assessed for competency in administering medicines and a comprehensive policy and procedure ensured that errors were thoroughly investigated if they happened.

People were supported to keep their homes clean and staff had a good understanding as to how to minimise the spread of infection.

Accidents and incidents were analysed, themes identified and risk assessments reviewed.

Assessments of need were completed before the provider agreed to provide a service to ensure the care provided would be suitable for them and manageable.

Staff completed an induction when commencing working for the provider. Regular supervision ensured staff felt supported in their roles.

People needed support tailored to their needs in order to maintain their diet, this was provided, and people were encouraged to eat healthily.

People received support to attend GP and hospital appointments and the provider had forged positive relationships with commissioners to enable a smooth process when people’s needs changed.

The service was compliant with the requirements of the Mental Capacity Act 2005.

People told us they felt their staff were caring and kind and we heard staff speaking about people in a respectful way.

People were supported to participate in care planning and each month would participate in a review of their person-centred plan.

Most people and their relatives felt staff treated people with respect. Dignity audits ensured that staff practice was constantly reviewed to ensure it was respectful and supported people to maintain their dignity.

Care plans were person-centred and held sufficient information about people’s likes, dislikes and aspirations.

The service met the requirements of the Accessible Information Standard.

People were supported to maintain and develop new friendships and relationships and to access a variety of activities both provided by the service and in the community.

Complaints had been dealt with according to the complaints procedure and staff and people were supplied with information about how to make a complaint.

The service was not providing end of life care to anyone when we inspected however they had been trained and had considered their approach when they needed to do so in future.

The management team were accessible and approachable. The culture of the service was empowering to people and staff.

The registered manager understood their responsibilities under the duty of candour.

The registered manager had clear oversight of the service and when things went wrong, practice was reflected on and learning taken from it.

Extensive quality assurance research was completed and the provider ensured that it investigated negative responses in an attempt to improve service experience for people.

The provider had positive links to health and social care services.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 23 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wessex Regional Care Domiciliary Service on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.