Archived: Workwise Healthcare Limited

Workwise is a domiciliary care agency. The service supports people receiving personal care in their own home. At the time of the inspection, 96 people were receiving support with personal care. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

‘As needed’ medicines were not managed safely, medicine records did not provide clear guidance to staff. Care plans guided staff on how to meet people’s daily routines and preferences. However, care plans lacked detail on people’s individual health conditions and how staff should respond to these. The registered manager has told us that they intend to resolve this.

Staff had made decisions for people who experienced confusion. However, documentation of people’s ability to make decisions had not followed the principles of the mental capacity act. Systems were in not fully place to clearly assess and support people’s decision making if needed. This puts people at risk of their decision making abilities not being effectively assessed.

The registered manager and staff were aware of their responsibilities and worked hard to create a good quality service. We identified concerns with medicine records, care plans and mental capacity assessments. We also identified concerns with the end of life policy and there was no evidence that people had been asked about their end of life wishes. The registered manager’s oversight and auditing of these areas had not identified these concerns. The concerns highlighted on inspection were responded to promptly and evidence sent that changes were being made. We will review the impact of this at our next inspection.

People told us that they felt safe at the service. Good hygiene practices were followed to keep people safe from the risk of infection. Incidents were reviewed, and action taken to keep people safe.

There were enough staff at the service and staff arrived at calls in a timely way. Some missed calls had occurred at the service, which meant staff had not arrived at the person’s house as expected. The registered manager had reacted appropriately to each circumstance and advised they were working to ensure this did not reoccur.

Most people told us that regular staff attended. These staff knew their needs well and had built a good relationship. People told us that when these staff had annual leave of sickness, new staff were sent to them. People reported that care was still a good quality however these new staff did not know their needs as well. This can have an impact on people who cannot communicate their needs as clearly.

Staff were well trained and received a structured induction to their role. Staff were safely recruited to ensure they were of good character. People were supported to eat and drink a balanced diet. Professional referrals were made if needed. These referrals had a positive impact on people’s well-being.

Staff were caring and kind to people. People were involved with making decisions about their care. Dignity was at the forefront of the service values. The service worked hard to reduce people’s loneliness. Free transport, and social activities were arranged for people. Those people that did not wish to go out, were supported with activities in their home. The service supported people’s complex communication needs with the use of accessible information.

Rating at last inspection

The last rating for this service was Outstanding (published 15 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Workwise Healthcare provides support to people in their own homes in Mansfield and the surrounding areas of north Nottinghamshire. At the time of our inspection 120 people were using the service.

The service had a registered manager in place at the time of our visit. 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.

People told us they felt safe receiving care in their homes from staff of Workwise Healthcare and did not have any concerns about the care they received. Staff knew how to protect people from harm and referrals were made to the appropriate authority when concerns were raised.

Risks to people’s safety were identified and managed, and assessments were carried out to identify how to minimise the risk of harm. For example in relation to falls or environmental risks.

People received care and support in a timely way and there were sufficient numbers of suitably qualified and experienced staff employed. Appropriate pre-employment checks were carried out before staff began work at Workwise Healthcare.

People who required support to take their prescribed medicines received assistance from staff to do so safely.

People were supported by staff who received training and support to ensure they could meet people’s needs. Ongoing training and assessment for care staff was scheduled to help maintain their knowledge.

People provided consent to any care and treatment provided. Where people did not have capacity to give informed consent their best interests and rights were protected under the Mental Capacity Act (2005). People’s wishes regarding their care and treatment were respected by staff.

People were supported by staff to maintain healthy nutrition and hydration. People had access to healthcare professionals when required and staff followed their guidance to ensure people maintained good health.

Excellent links were established with healthcare professionals and people had access to these when required. Staff worked in partnership with healthcare professionals and followed their guidance to ensure people maintained good health.

People told us they were treated with compassion dignity and respect and staff ensured their privacy was protected. We observed very positive, caring relationships between staff, people using the service and their relatives. Staff always ensured that people and their relatives were involved in making decisions about their care and their wishes were respected. .

Staff had an excellent understanding of people’s support needs and used skill and innovative methods to ensure they received personalised responsive care. Forethought and innovation was used to ensure that people had the opportunity to take part in enjoyable, constructive activities that reflected their interests and life history.

There was an open and transparent culture at the service. People were encouraged to raise any issues or complaints and could be assured these would be listened to and acted on by the provider. Quality monitoring systems were in place to identify areas for improvement and ensure these were actioned.