Archived: Wiltshire Care at Home Service

Updated 30 December 2015

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.

This visit to the service took place on 1 December 2015 and phone calls were made to people who use the service on 30 November and 2 December 2015. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a home care service. We wanted to make sure the registered manager would be available to support our inspection, or someone who could act on their behalf.

The inspection was completed 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. Before the inspection, we reviewed all of the information we hold about the service, including previous inspection reports and notifications sent to us by the provider. Notifications are information about specific important events the service is legally required to send to us. We reviewed the Provider Information Record (PIR). The PIR was information given to us by the provider.

As part of the inspection we spoke with 13 people who use the service, three relatives, the manager, and 14 staff involved in the delivery of care to people. We looked at the records relating to care and decision making for nine people who use the service. We also looked at records about the management of the service. We received feedback from three health or social care professionals who have contact with the service.

Updated 30 December 2015

Leonard Cheshire - Wiltshire Care at Home Service is contracted by Wiltshire Council to provide a care at home service for people who live in Swindon, Malmesbury, Calne and surrounding areas. At the time of our inspection over 400 people were receiving personal care from the service. The service was last inspected in October 2014 and was found to be meeting all of the standards assessed.

This visit to the service took place on 1 December 2015 and phone calls were made to people who use the service on 30 November and 2 December 2015. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a home care service. We wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

The service did not have a registered manager in post. 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 and associated Regulations about how the service is run. The service has a condition of their registration that a registered manager must be in post. Since the last registered manager left in September 2015, the service has been managed by one of the locality managers. The manager told us she had submitted an application to CQC to be the registered manager shortly before the inspection. Records confirmed this application had been received by CQC and was being assessed.

The systems in place to manage risks related to the administration of medicines were not completed consistently. Information on how to provide support to people with their medicines was not always available. The missing and contradictory information increased the risk that staff would not provide support that people needed with their medicines or provide support to people that was unsafe.

The provider’s systems for gaining and recording consent for care and treatment were not always followed by staff. This meant it was not possible to say whether some people consented to the care and treatment they were receiving, or if they did not have capacity to consent to their care that requirements of the Mental Capacity Act had been followed.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff. Comments from people included, “They are very good, very caring”, “Yes, they are caring. They are not rude or clumsy, they’re very nice” and “They are very kind to me”. A relative also expressed satisfaction with the caring way staff supported their family member, commenting, “They are definitely kind and caring. They talk to (my relative) and tell him what they are going to do”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them. People said the care workers generally arrived on time, and they would receive a call to inform them if there were any problems.

Staff understood the needs of the people they were providing care for. Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service and demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs. However, the training records were not all up to date, which made it difficult for the management team to keep a track of training staff had completed and to plan future training events.

The service was responsive to people’s needs and wishes. People had opportunities to provide feedback about their care and there was a complaints procedure. Although people said they would raise any concerns with staff, they were not all aware of the formal complaints procedure for Leonard Cheshire. The manager said they would look at the information they were sending out to review whether it could be provided in a clearer way.

The provider regularly assessed and monitored the quality of the service provided. Feedback from people and their relatives was encouraged and was used to make improvements to the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.