We carried out a review of the data available to us about Weston Business Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Weston Business Centre, you can give feedback on this service.
About the service
Weston Business Centre is a domiciliary care service providing the regulated activity of personal care to 11 people, this included both adults and children who have a learning disability, are autistic and who have complex care and support needs.
People’s experience of using this service and what we found
Right Support:
The staff team supported people to have choice, control and independence. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.
The service worked with people to plan for when they experienced periods of distress so that their freedoms were not restricted.
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.
Staff supported people with their medicines in a way that promoted best possible health outcomes.
Right Care:
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
Staff assessed risks posed to people using the service. Where appropriate, staff encouraged and enabled people to take positive risks.
Right Culture:
Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.
Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
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 14 September 2018]
Why we inspected
The inspection was prompted in part due to concerns received about the quality of care provided for people using the service. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Weston Business Centre on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have made a recommendation about the service’s recruitment practices.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Not everyone using Weston Business Centre receives personal care; 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. At the time of the inspection the registered provider was providing support to nine people.
Following the last inspection on 29th June 2017 and 4th July 2017, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well led to at least good. At the last inspection we rated both these key questions as requires improvement and identified that the service was breaching regulation 18 as the registered person did not ensure there were sufficient numbers of suitably qualified, competent, skilled and experienced staff deployed in order to meet the provision of the regulated activity. There were not enough staff to ensure all peoples needs were met. This was predominantly noted with three out of 14 people who were receiving 24 hour care packages. Staff were working extremely long hours with no break. We additionally identified that a lack of effective management and a lack of oversight, with no registered manager did not fully ensure the service delivered was safe and continued to improve. This with particular relevance to the monitoring of staff working hours, Systems in place required developing to show how the service was moving forward.
During this comprehensive inspection we found improvements had been made in two key questions and have changed the rating for the domains 'Safe' and 'Well-led' to Good. We have kept the rating for 'Effective',' Caring' and 'Responsive' as Good. The overall rating for the service has improved and changed from ‘Requires Improvement’ to 'Good'.
A registered manager is now in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
We found people who used the service were protected from the risk of harm and abuse because staff had received safeguarding training and they knew what to do should they have any concerns. Staff were recruited safely.
People received their medicines as prescribed and the registered manager had implemented procedures to ensure documentation relating to medicines was robust.
People who used the service had a wide range of support needs. Some people required support from the service 24 hours a day and other people were more independent and received support for just a few hours a day to help with their daily routines. There were enough staff to meet people's needs and new staff had recently been recruited to maintain appropriate numbers of staff.
People are supported to have maximum choice and control of their lives and staff do support them in the least restrictive way possible; the policies and systems in the service do support this practice. We found the registered manager and staff understood their responsibilities under the Mental Capacity Act 2005. They were aware of the need to gain consent when delivering care and support, and what to do if people lacked capacity to agree to it.
People's abilities to make decisions had been assessed and appropriate support had been provided to ensure that their views were taken into account when making decisions. Relatives and other professionals had been involved when important decisions about care had to be made.
Positive and caring relationships had been developed between staff and people who used the service. We saw people were treated with respect and their dignity was maintained. Staff were overheard speaking with people in a kind, attentive and caring way.
Staff supported people to be involved in their care and to make choices about how they spent their time. Wherever possible staff encouraged people's independence and supported them to access the local community.
Care plans contained information on the care people needed and the risks they faced. Staff were aware of people's health care needs and the support they provided helped to maintain them.
Staff liaised with health and social care professionals for advice and guidance when required.
People told us they liked the meals provided and were offered support to prepare their own meals when they wished to do this.
Staff training and the on-going support staff received from the management team meant that the care provided was calmly delivered, safe and effective.
There was a formalised quality monitoring system that ensured people's views were listened to, any complaints were addressed, audits were completed and checks were carried out on staff practices and performance.
Further information is in the detailed findings below
Mashdel Services had a registered manager in post who resigned from their post two weeks before our inspection. A new manager had been appointed but as yet was not registered. 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.'
There were not enough staff to ensure all peoples needs were met. This was predominantly noticed with three out of 14 people who were receiving 24 hour care packages. Staff were working extremely long hours with no break.
Most people felt safe and were cared for by staff in way that promoted their dignity and met their needs. Staff knew how to identify and report concerns that affected people's health and wellbeing.
People were supported to take their medicines safely. People’s medication records were completed correctly and when needed written protocols were in place for example for when people required drugs for pain relief or had swallowing difficulties.
People were supported to eat and drink to maintain a balanced diet. People had a variety of choice and their dietary requirements were met.
Staff respected people's wishes and preferences in the way they delivered care. Where people were able, they were involved in the planning of their care. Staff understood how to support people who may not have capacity to make certain decisions about their care.
People were encouraged to follow their interests and were supported to take part in activities that they enjoyed.
The registered provider reviewed untoward incidents and accidents and looked for opportunities to improve practices. There were systems in place for handling and resolving complaints.
People were supported by staff that had been employed following appropriate recruitment checks. This ensured they were safe to work in health and social care settings. Staff recruited had the right values and skills to work with people who used the service. Staff received training and support which ensured they had the qualifications and skills to deliver good quality care to people.
The registered provider demonstrated a desire to provide good leadership to the staff team. Audits were completed to assess the quality of the service; however a lack of effective management and a lack of oversight did not fully ensure the service delivered was safe and continued to improve. This with particular relevance to the monitoring of staff working hours, Systems in place required developing to show how the service was moving forward.
You can see what action we told the provider to take at the back of the full version of the report summary.