Archived: Westminster Homecare Ltd (Crawley)

We reviewed information sent to us by the provider and spoke with four members of staff and the provider's operations manager on the telephone. We found improvements had been made and the provider had taken action to ensure there were now enough care workers to meet the needs of people who used the service.

At the time of this review the service did not have a registered manager in place. The provider had notified us of this on 21 May 2014. We spoke with the provider's operations manager who was one of the managers providing support to the location. They told us a new manager had been appointed and they would be applying for registration. However we had not received an application at the time of this review. We reminded the provider of the legal implications of continuing to operate without a registered manager.

In this report the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time. The manager from one of the provider's other locations was supporting staff at this location for one or two days a week and is referred to as 'the manager' in this report.

This is a summary of what people told us and what we found.

Is the service safe?

People who used the service told us they felt safe and comfortable when they were with their care workers. People's relatives said their family members had a good relationship with their care workers. They were satisfied the care workers were trained and prepared to deliver care safely. One person said their care workers were 'more like friends'.

We found the service carried out the necessary checks before staff started work and there was a robust recruitment process in place. People told us staff took appropriate steps to avoid the spread of infection. Induction training for new staff included training in infection control. The provider was not fully following published guidance on the prevention and control of infections.

Is the service effective?

People told us that they were satisfied with the care and support they received. One said the service was 'excellent' and another said it was 'brilliant'. One relative described themselves as 'quite happy' with the service. Another relative said they 'could not fault the service'.

We found people's care and support were based on thorough assessments and detailed and personalised support plans. Systems were in place to ensure care was delivered according to people's plans.

Is the service caring?

Relatives of people using the service told us support was provided in a caring way. One said their family member's care workers were 'absolutely gorgeous'. Another relative said the care workers had a good understanding of their family member's needs and listened to him if he wanted to change his routine. People using the service told us they got on well with their care workers and had a good relationship with them. One said, 'Sometimes I get a telephone call because they know I worry.'

Is the service responsive?

People told us the care they received was based on an understanding of their needs and how they preferred to have their needs met. They were satisfied with their care plan assessments and that care was delivered according to their plans. There were regular reviews of their care plans. They told us staff listened and were responsive when they contacted the office.

We found the service had systems in place to ensure the care provided was appropriate to people's changing needs.

Is the service well-led?

At the time of our inspection the registered manager and an operations manager assigned to support the branch had recently left. One third of the active care workers had joined in the previous five months. The manager told us steps were being taken to recruit a new full time registered manager. According to its own calculations the service did not have enough care workers to support the programme of visits it had committed to. The manager told us the shortfall was being managed by staff working extra hours. They were taking steps to recruit more care workers.

Systems were in place to regularly assess and monitor the quality of service provided. Risks were assessed and appropriate action plans were in place.

We saw that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We noted that staff were supported in delivering safe care. This meant that the care was of an appropriate standard. We also found that the provider had an effective system to regularly assess and monitor the quality of service that people received.

We looked at the agency's recruitment practices and we found that checks had been completed before new staff started work in the agency. This ensured that people who used the agency were protected from unsafe or inappropriate care.

We found that staff were well trained and supervised to enable them to deliver safe care and support to people. Staff we consulted with said that they enjoyed working at the agency and that they received all training necessary to undertake their duties.