Westwood Care and Support Services Yorkshire Ltd

This inspection took place on 12 November and was announced. At the last inspection on 17 March 2016 we rated this service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Not everyone using Westwood Care and Support Services Yorkshire Ltd 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 care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was in place at the time of our inspection. 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.

The provider had policies and procedures in place to support staff to administer medicines safely. We identified minor concerns in relation to auditing of medicines administration which was addressed by the provider during this inspection. Risk assessments were in place, and the provider was in the process of updating some of these records to include additional detail to guide staff when mitigating risks to people. Staff received training to safeguard children and people from potential harm or abuse and could explain the services procedures for dealing with any safeguarding concerns. Recruitment processes were robust and included pre-employment checks to ensure people were suitable to work with children and older people.

Staff felt that communication could at times be improved in certain areas. The provider told us this was a work in progress and had measures in place to address any issues raised. Staff received regular supervisions. Some of these were brief in detail and not fully completed to utilise all sections such as feedback from other staff and people receiving services. The provider told us this would be immediately addressed and further training had been provided to staff following this inspection to promote a consistent approach. Appraisals were scheduled.

Inductions were comprehensive and included training that supported staff to deliver effective care and support to people. Staff were encouraged to work towards further qualifications to develop and maintain their knowledge and skills. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff worked with health professionals to build productive relationships which encouraged good outcomes for those people receiving services. People told us that their views were sought and suggestions for improvements actioned. People felt their diverse needs were accommodated by all staff.

Care plans were personalised and included information about peoples likes, interests and preferences. The provider was in progress of improving information around people’s specific health conditions and how to best support them. Reviews of care were completed regularly and people important to those receiving services were encouraged to participate. Social activities were varied and took into consideration people's likes, dislikes and suggestions. We saw positive feedback from people that received services and their parents and carers.

The service engaged people and their relatives or carers through regular review of their needs, home visits and satisfaction surveys. Management meetings supported staff to address any concerns and share best practice guidance.

Feedback about the leadership and management of the service was overall positive. People described the registered manager as approachable and supportive.

Further information is in the detailed findings below.

This inspection took place on 17 and 24 March 2016. The inspection was announced. We previously visited the service on 11 December 2013 and we found that the registered provider met the regulations we assessed.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run.

We found that staff had a good knowledge of how to keep people safe from harm and there were enough staff to meet people's needs. Staff had been employed following appropriate recruitment and selection processes. We found that people's needs were assessed and risk assessments put in place to keep people using the service and staff safe from avoidable harm. We found that the administration of medicines was being audited; however, we identified some inconsistences in the management of one person’s medication. We have made a recommendation about this in the report.

We saw that staff completed an induction process and they had received a wide range of training, which covered topics including safeguarding, moving and handling and infection control. Staff told us they felt well supported; they received supervision, appraisals and attended team meetings. Staff were also encouraged to complete an NVQ Level 2 or higher. People were supported to make decisions and choices. Staff received training on the Mental Capacity Act 2005 and had knowledge sufficient for their role.

Some people told us they received support from staff with shopping, cooking and domestic tasks. They were involved in choosing what items they wanted staff to buy or what they wanted making and were generally satisfied with the meals prepared. People were supported to access healthcare support where necessary.

People told us staff were caring and that they had developed positive relationships with people who supported them and they were treated with respect by the agency’s staff. People were generally happy with the service they received and told us that the staff usually arrived on time. They told us that they received support from the same member of staff or group of staff and they developed a good rapport with carers. People were supported to access their local community, go for days out and go on holiday.

We saw that people's needs were assessed and care plans put in place to enable staff to provide responsive care and support. People had been involved in the planning of their care and relevant people were included in care plan reviews. However, we found that care plans sometimes lacked sufficient detail in relation to specific care tasks. We made a recommendation about this in the report.

People were supported to make choices and decisions and to feedback any concerns. There were appropriate complaints procedures in place should people need to raise any issues. We saw that these were always investigated; however, the outcome of two investigations had not been signed off due to extenuating circumstances.

People using the service and agency staff told us the service was well-led. We could see there were systems in place to monitor the quality of care and support provided and evidence that action was taken to address any concerns. However, we found shortfall’s in the management of one person’s medication which could have been detected through increased quality checks. The registered manager decided they would carry these out weekly, instead of monthly, in future.

We found that peoples' privacy, dignity and independence were respected and peoples' views and experiences were taken into account in the way the service was provided and delivered in relation to their care. They said, "I was asked about everything", "I was provided with some information about the service" and "Westwood involved me in putting my package together. The carers always do things how I want them doing".

From speaking with people that used the service we found that care and treatment was planned and delivered in a way that was intended to ensure peoples' safety and welfare. People said, "The personal assistants treat me like a lady. I am highly delighted with what they do for me", "I am quite happy with everything", "The personal assistants are excellent. The service is flexible and meets my needs in every way" and "My personal assistants know me well and understand my condition".

We found that peoples' health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in cooperation with others.

We also found that people were protected from the risk of infection because appropriate guidance had been followed. People said, "My house is spotless" and "The personal assistants follow good hygiene practices. They wear personal protective equipment: aprons and gloves." People were also cared for or supported by suitably qualified, skilled and experienced staff.

We saw that the provider had an effective system to regularly assess and monitor the quality of service that people received, which meant that people received an improved service of care whenever possible.

We found that people were satisfied with the service and though they had not been entirely without problems, these had been rectified to their satisfaction. People told us, 'The staff are very good, we get on well now', 'I have always had staff arrive pretty much on time and they have never missed a call', 'My daughter really likes the staff that take her out and I know she is safe with them.'

We found the agency to be organised, well managed and receptive to peoples' care and support needs, as staff worked in teams and were usually matched to people that used the service.

The agency provided good opportunities for staff to complete required training and all staff were well trained on a yearly basis.

The agency had effective systems for handling complaints.