We carried out a review of the data available to us about Wirral Mind 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 Wirral Mind, you can give feedback on this service.
This service provides a domiciliary care service and provides care and support to eighteen people living in their own homes. The care and support is provided by Wirral Mind staff so that people are supported to live in their own homes as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate the premises where people lived; this inspection looked at people’s personal care and support.
The service had a registered manager who had been in post since 2011.
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.
Care records and risk assessments were well-kept and up-to-date. Each person using the service had a personalised support plan and risk assessment. All records we saw were complete, up to date and regularly reviewed. We found that people and their relatives were involved in decisions about their care and support. There was an emergency continuity plan in all files looked at that would be used if for example the person was taken to hospital. The information was a summary of the care and support required and other relevant information. We also saw that medications were handled appropriately and safely.
We found that recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service and disciplinary procedures had been followed appropriately and in accordance with policies. Staff received a comprehensive induction programme, regular training and supervision to enable them to work safely and effectively.
People's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary. The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place and training to guide staff in relation to safeguarding adults.
The service had quality assurance processes in place including audits, staff meetings and quality questionnaires. The services policies and procedures had been regularly reviewed by the provider and these included policies on health and safety, confidentiality, mental capacity, medication, whistle blowing, safeguarding and recruitment.
People told us they were happy with the staff and felt that the staff understood their support needs. The people and the relatives we spoke with had no complaints about the service. The provider had a complaints procedure in place and this was available in the ‘service user guide’.
Wirral Mind is a domiciliary care service that provides care and support to people with learning disabilities and mental health needs. Support is provided in the community and within supported living services to people who live in the Wirral area. At the time of the inspection there were sixteen people being supported by the service.
The manager was registered with the CQC and had been in post since September 2011. 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.
During the inspection we found positive examples relating to the care being provided to people. However we also identified some aspects of the service that needed improvement.
Information relating to the safe recruitment of staff was not available after some of this information had been deleted due to a problem with the IT system. The registered provider had identified 27 staff whose references had been deleted, and we identified an additional one. This impacted upon the registered provider’s ability to demonstrate safe recruitment practices. Whilst efforts had been made to prevent this from occurring again in the future, this also highlighted issues around the safe storage of information.
You can see what action we told the provider to take at the back of the full version of the report.
The registered provider was not always aware of their duties with regards to the Mental Capacity Act 2005 (MCA). Mental capacity assessments had not been completed for people using the service, in accordance with the law. We have made a recommendation around the use of the MCA within the service.
Full-time staff had received training in key areas to ensure that they had the skills and knowledge needed to carry out their roles. This included training in the MCA, safeguarding and first aid. We identified that a system was needed to ensure that bank staff had the necessary skills and knowledge. Bank staff are temporary staff who are used on an ‘ad hoc’ basis to fill gaps where there is a shortfall in staff. The registered manager confirmed that this would be put in place, and following the inspection we received confirmation to show that this was being done.
People were protected from the risk of abuse. Staff were aware of the different types of abuse and how to report any concerns that they may have. The registered provider had a safeguarding policy and procedure in place which staff were aware of.
A record of accidents and incidents was maintained, and records showed action had been taken to prevent incidents from happening again in the future. For example one person had been referred to the occupational therapist so that the necessary equipment could be put into place to support them. This ensured that people’s wellbeing was maintained.
People were supported to take their medicines as prescribed. Staff signed medication administration records (MARs) to show that these had been given as required. Staff had also supported people with accessing support from health professionals when they were unwell. This protected people from the risk of poor health.
People were supported to eat and drink sufficient amounts to meet their dietary requirements. Their care records contained details around any special dietary requirements they may have. Staff were aware of people’s dietary needs and ensured that these were provided for.
Staff were kind and caring towards people. People’s family members commented they felt their relatives were being well looked after by staff and we saw examples where positive relationships had been developed. Staff worked to promote people’s dignity and acted to relieve any discomfort or distress when it arose.
People’s care records contained detailed and personalised information regarding their care needs. This was reviewed on a regular basis which ensured that staff had access to up-to-date, relevant information about how they should support people.
People were protected from the risk of social isolation. There were activities available to people and their family members commented that they were “always out”. Staff had time to spend with people, and we saw examples of them doing activities such as painting, or sitting and talking to people.
There were audit systems in place to ensure that the quality of the service was being maintained. Audits of medicines, people’s care records, accidents and incidents and people’s finances were carried out regularly to ensure that there were no issues. Where issues were identified actions were taken to remedy these and prevent them from occurring again in the future.
We looked at six support plans. They showed that people were involved in the care that was planned. Each plan had a health action plan that showed the consent process was explained in pictorial format so consent could be appropriately obtained.
Where applicable, we saw that people had a 'budget support plan' in addition to their support and health plans. Staff told us they assisted people with their daily finances and we saw an audit trail was in place for each person's expenditure.
We saw that the provider had recruitment policies and procedures in place to ensure that people weren't discriminated against during the recruitment process. We found that people who used the service were also involved in the recruitment of new staff and had the opportunity to take part in the interview process.
We found there was an effective system in place to deal with complaints. It was evident there was a detailed audit trail of how concerns were managed and dealt with to the complainants' satisfaction where possible.
Records showed the provider proactively worked to involve people in the service development and improvement of Wirral Mind. For example one person who used the service was a member of the board of directors other people were involved in the recruitment and selection of staff and regular service user meetings took place.
Support plans viewed provided the support workers with information about the type of care and support people needed. They also included risk assessments that provided support workers with information about any risk that may be present to them or the people they were supporting.
Records held by CQC showed the service had sought advice with regard to safeguarding issues and concerns.
Records showed that all support workers completed follow on training around health and safety matters such as medication management, safeguarding, food hygiene and infection control. Specialist training was also provided by the provider and an external training provider for example mental health and autism awareness and dementia care.
People who used the service told us they were happy with the service they received and felt confident any concerns they raised would be dealt with. People also told us they were asked their views about their care and support and they were acted on.