Archived: Caring Companions at Watling Court

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

There were sufficient staff available to support people’s needs; however, people told us staff punctuality could be better. The provider followed appropriate recruitment practices and staff were checked before they began working at the service.

People told us they felt safe and had not experienced any abuse, neglect or discrimination. People were protected from the risk of avoidable harm because risks to people had been identified, assessed and had appropriate risk management plans in place. People’s medicines were safely managed. People were protected from the risk of infections. Lessons were learnt from accidents and incidents and management plans were put in place to prevent any repeat occurrences.

Before people began using the service, their needs were assessed to ensure they would be met. Staff were supported through induction, training and supervision to ensure they had the knowledge and skills to support people safely. People were supported to eat and drink sufficient amounts for their health and wellbeing. People had access to healthcare services and the staff worked in partnership with health and social care professionals to plan and deliver an effective service. 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.

People were supported by staff that were kind and caring. People were involved in making decisions about their care and support needs and had choice and control over their lives. People’s privacy and dignity was respected, and their independence promoted.

People told us the care and support in place was meeting their needs and if they were unhappy they knew how to make a complaint. People’s communication needs had been assessed and met. The service had systems in place to assess and monitor the quality and safety of the service and to continuously learn to drive improvements. The service worked in partnership with key organisations to plan and deliver an effective service.

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 18 May 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.

Personal care is provided to people by the domiciliary care agency, which is known operationally as Caring Companions, based at Watling court. However, people can choose to use other care agencies if they prefer. Longer calls can be agreed for support to bathe and shower and shorter calls can be provided for help with medicines. The registered provider refers to the people using the service as tenants. There were 49 people using the personal care service at the time of the inspection. This inspection was carried out on 17 March 2017 and was unannounced. The inspection was carried out by one inspector.

There was a manager in post who was 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.

At our inspection on 3 March 2016 we found breaches of regulation relating to consent, governance, staff recruitment and staff training. At this inspection we found that improvements had been made and the regulations were being met.

People told us they were very happy using the service and felt safe and well cared for. The registered manager had ensured the culture of the service was person centred and flexible to meet people’s needs and wishes.

People were protected by staff that understood how to recognise and respond to signs of abuse. Risks to people’s wellbeing were assessed and staff knew what action they needed to take to keep people safe. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced.

There was a sufficient number of staff on duty at all times to meet people’s needs in a safe way. The registered provider had systems in place to check the suitability of staff before they began working in the service. People and their relatives could be assured that staff were of good character and fit to carry out their duties. Staff had completed training and qualifications relevant to their role. The registered manager monitored staff training needs to ensure that staff were skilled and competent to meet people’s needs. Staff felt supported in their roles.

Staff identified and met people’s health needs. Where people’s needs changed they sought advice from healthcare professionals and reviewed their care plan. Records relating to the care of people using the service were accurate and complete to allow the registered manager to monitor their needs. People had enough to eat and drink and were supported to make choices about their meals. Staff knew about and provided for people’s dietary preferences and restrictions. Medicines were stored, administered, recorded and disposed of safely and correctly.

Staff communicated effectively with people and treated them with kindness and respect. They knew people well and understood what was important to them. People’s right to privacy was maintained. Staff promoted people’s independence and encouraged people to do as much as possible for themselves. Personalised care and support was provided at an appropriate pace for each person so that they did not feel rushed. Staff were responsive to people’s needs and requests.

Staff sought and obtained people’s consent before they helped them. People’s mental capacity was assessed when necessary about particular decisions. Meetings were held, when needed, to make decisions in people’s best interests, following the requirements of the Mental Capacity Act 2005. Some documentation in people’s care plan files that related to consent was out of date. We have made a recommendation about this.

People were involved in making decisions about their care and treatment. Clear information about the service and how to complain was provided to people and visitors. The registered provider sought feedback from people and used the information to improve the service provided. People were involved in developing and improving the service through tenants meetings, and quality surveys.

There was a system for monitoring the quality and safety of the service to identify any improvements that needed to be made. Action had been taken to address any shortfalls.

Some policies and procedures were out of date and required reviewing. We have made a recommendation about this.

Watling Court is a domiciliary service that provides personal care and support to tenants who live in independent living flats located in a purpose built facility. The main office is located within the living facility at Watling Court. There were 47 people receiving support to meet their personal care needs on the day we inspected.

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.

People’s views about the service they received were positive. Relatives felt their family members received safe, effective, compassionate, responsive and well led care.

Recruitment practices were not always safe, gaps in employment history had not always been explored.

Medicines were appropriately managed and administered. They were not always appropriately recorded. We made a recommendation about this.

Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) was in place which included steps that staff should take to comply with legal requirements. Capacity assessments did not follow the principles of the Mental Capacity Act.

Systems to monitor the quality of the service were not effective. Policies and procedures were out of date, which meant staff didn’t have access to up to date information and guidance.

Staff knew and understood how to safeguard people from abuse, they had attended training. The registered manager had appropriately reported safeguarding concerns to the local authority but had not reported this to CQC. The local authority’s policy, procedures and protocols where not available for staff or the registered manager. We made a recommendation about this.

Staff had not received regular support and supervision from their line manager. There were suitable numbers of staff on shift to meet people’s needs.

People’s information was treated confidentially. People’s paper records were stored securely in locked filing cabinets.

People received medical assistance from healthcare professionals when they needed it. Staff knew people well and recognised when people were not acting in their usual manner.

People’s care plans detailed what staff needed to do for a person. The care plans included information about their life history and were person centred.

People had choices of food at each meal time which met their likes, needs and expectations. People were supported to be as independent as possible.

People and relatives told us that staff were kind, caring and communicated well with them.

People and their relatives had been involved with planning their own care. Staff treated people with dignity and respect.

People were given information about how to complain. This was displayed in communal areas of Watling Court.

People’s view and experiences were sought through review meetings and through surveys.

People told us that the service was well run. Staff were positive about the support they received from the manager. They felt they could raise concerns and they would be listened to.

Communication between staff within the service was good. They were made aware of significant events and any changes in people’s behaviour.

We found several 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.

People seemed at ease with staff and it was clear that strong professional relationships had been formed. People told us they were involved in their care and were happy with the support provided by the service. Comments included "It's nice", "They provide a very high standard of care" and "I always know what's happening".

We saw that staff respected the privacy and dignity of people by knocking on their front doors and speaking appropriately to them. People told us that staff were "Nice and always chatty" and made them feel "Safe".

We found that people were supported by regular staff who understood their health and social needs. People said that they found the management of the service to be very approachable and open to feedback. They said the manager had responded appropriately to any concerns they had raised.

We saw that the service had good quality assurance systems in place to ensure that the care and support provided was effective and people received a high quality of care.