Wishes Care and Support Yorkshire

Wishes Care and Support Services is a domiciliary care agency providing care and support to people in their own home. At the time of inspection, the provider delivered services to 163 people. Not everyone who used the service received personal care. The Care Quality Commission (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

Improvements had been made since the last inspection. Systems and processes in place ensured people were protected from abuse. Staff had the knowledge and skills to protect people from abuse and people said they felt safe.

Improvements have been made to staffing levels, the service had recruited new staff to ensure appropriate staffing levels. A thorough recruitment process was in place to ensure staff recruited were suitably trained and skilled to carry out their role.

Care plans were detailed and person-centred and provided clear guidance to staff on how to care for people effectively. Care plans were regularly reviewed and updated when required.

Medicines were managed safely.

People and their relatives told us the management and staff were approachable and knowledgeable. Regular audits carried out helped improve the service when needed.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. The model of care and support provided to people maximised their choice, control and independence. People were involved in all aspects of their care and future planning. Care provided was centred around the person and promoted people’s dignity, privacy and human rights. The ethos, values, attitudes and behaviours of the management team and support staff ensured people lead confident, inclusive and empowered lives.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 September 2021) and there was breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that systems and processes were in place to safeguard people and that there were enough suitably trained staff. At this inspection we found improvements had been made.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Wishes Care and Support Yorkshire on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

Wishes Care and Support Services is a domiciliary care agency providing care and support to people in their own home. At the time of inspection, the provider delivered services to 180 people. Not everyone who used the service received personal care. The Care Quality Commission (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

The provider failed to submit statutory notifications to CQC for all reportable incidents in line with their regulatory responsibilities.

We found inconsistencies in both the provider’s and staff members approach to managing accidents and incidents and risks to people using the service. The provider had failed to implement outcomes of investigations relating to safeguarding concerns, including accidents and incidents.

There was no oversight by the provider or registered manager in relation to the quality and safety of the service. Therefore, opportunities to learn lessons and drive improvements had been missed.

Staff were recruited safely and attended a full programme of induction.

People told us their care staff were kind and considerate, they told us they felt safe.

Staff told us the management team were open and transparent and supported them with any issues or concerns.

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.

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 7 October 2017).

Why we inspected

The inspection was prompted in part due to concerns received about people’s safety and the management of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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.

At the last inspection the service was rated good overall, but ‘requires improvement’ in the 'effective' section. This was because staff training was not up to date although training was booked to be completed. We recommended that the registered provider monitored the staff’s training to make sure their skills were kept up to date. We also found staff appraisals had not been carried out. During this inspection in September 2017 we found these issues had been fully addressed. Therefore, the service remained 'Good'.

The service 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.

Staff knew how to recognise and report potential harm or abuse. Safeguarding issues raised were reported and acted upon. Incidents and accidents were investigated. Risks to people’s wellbeing were assessed and reviewed. Infection control was in place to maintain people’s safety. New checks and audits in relation to medicine management had just been introduced to help staff monitor and maintain people’s health and wellbeing.

There were enough staff available to meet people's needs. Training was provided in a variety of subjects to develop and maintain the staff’s skills. Supervision and appraisals were undertaken to support the staff. People were supported to eat and drink, where appropriate.

People had choice and control of their lives, staff told us how they gave people choice and supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

Information was shared with people and their relatives about what the service could provide. People were involved in making decisions about their care and support. People we spoke with told us the staff were caring and they were positive about the service they received. Confidential information was stored securely to maintain people’s privacy. End of life care was provided.

People’s care needs and preferences were recorded. Reassessments of people’s needs occurred as people’s needs changed. Complaints raised were investigated and this information was used to help to improve the service.

An ‘on call’ system operated outside of office hours to allow people, their relatives or staff to gain help and advice, at any time. Quality monitoring checks and audits were in place. Senior staff undertook ‘spot checks’ to observe how staff delivered care. People were asked for their views and feedback about the service was acted upon.

Further information is in the detailed findings below.

Wishes Care and Support Yorkshire is a domiciliary care agency which is located in Hull. The service provides personal care and support to people living in their own home. At the time of the inspection there were 130 people using the service. People using the service and their relatives were able to visit the office. Car parking facilities were provided in the local streets or outside the office.

The service has a registered manager in place. 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

Staff understood they had a duty to protect people from harm and abuse. They understood how to report concerns about potential abuse to the management team, local authority or to the Care Quality Commission (CQC). This helped to protect people.

People’s preferences for their care and support were known by staff. Care plans were in place to inform staff about people’s individual needs. Risks to people’s health and wellbeing, as well as potential risks in their home environment were assessed and monitored. Staff contacted relevant health professionals for help and advice to help maintain people’s wellbeing.

People’s nutritional needs were assessed and they were kept under review to make sure their dietary needs were met. People choose what they would like to eat or drink to promote their appetite.

Training was provided to new staff in a variety of subjects to promote people’s health and wellbeing. This was provided through the ‘Care Certificate’, (A nationally recognised training programme). We found staff who had worked at the agency for some time did not have all their refresher training up to date. The registered provider was aware that this training had slipped and there were dates in place with staff allocated to the training courses to address this. We recommend that the registered provider monitors the training undertaken to make sure the staff's skills are kept up to date.Training in medicine management and administration was provided. People we spoke with told us they were well cared for and said the staff had the skills they needed to meet their needs.

There were enough staff to meet people’s needs. Staff received supervision and a programme of staff appraisals had just commenced. This helped to identify further training needs and allowed discuss to be held about staff performance.

Staff understood that if people lacked capacity to make their own decisions then the principles of the Mental Capacity Act 2005 and codes of practice must be followed, which helped to protect people’s rights. Staff we spoke with told us how people consented to receive their care and support.

An ‘on call’ system was in place. Evening cover was provided by staff located at the registered provider’s office. During the night people or their relatives were able to call a phone number for help and advice which was provided by senior staff.

We visited one person who used the service. They informed us they were satisfied with the care they received and praised the caring nature of the staff who attended to them.

People were asked for their views about the service they received. Feedback was acted upon to help maintain or improve the service provided.

The care records of people including people’s medicine administration records were looked at when they were returned to the office for storage. They were also inspected during ‘spot checks’ undertaken by senior staff to monitor the quality of the service. No formal auditing of people’s care records was in place. The registered provider told us an auditing system was about to be introduced to address this.

People were provided with a complaints policy. It provided people with information about how to make a complaint and how the issue raised would be investigated and responded to. Issues raised were dealt with appropriately.