We carried out a review of the data available to us about Welcome Support 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 Welcome Support, you can give feedback on this service.
Welcome Support is a domiciliary care agency providing personal care. The service provides support to older people and those with a physical or learning disability within their own homes. 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. At the time of our inspection there were six people using the service and receiving personal care. The registered provider told us they were planning to expand the service following the inspection and change to the rating.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support: The model of the service was person centred and promoted independence. 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 had their needs assessed and there were enough skilled staff to ensure people had their needs met in a personalised way.
Right Care: People valued the support they received and they told us they were treated well by staff. One person’s relative said, “They are all very good to her and she likes them, they are just so lovely with her and with (other relative), so kind and caring. I can’t praise them enough.” Staff demonstrated respect for the people they cared for. The service worked well with other professionals to ensure people’s needs were met and they were safe. There were safe and effective systems in place for ensuring people had their medicines.
Right Culture: The registered manager and staff demonstrated a commitment to person centred values. There was an ethos of continuous improvement and the registered manager demonstrated duty of candour when things went wrong. Staff understood how to recognise the signs of abuse and were confident to report any concerns.
Rating at last inspection and update
The last rating for this service was requires improvement (published 23 October 2021) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 15 September 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the governance of the service.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain that requirement.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The previous ratings for Effective and Caring were good. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Welcome Support on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Welcome Support is a domiciliary care service providing personal care for people in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks such as personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection the service was supporting five people, some of whom had complex support needs including, dementia.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
People’s experience of using this service and what we found
The auditing and governance systems in place were not effective. Care records contained inconsistent information regarding how staff should meet the person’s needs. Some records were very detailed, describing the exact support the person required and how staff were to use any specific aids or equipment. Whereas, other records were very sparse in the level of detail. Following the inspection, the registered manager completed, reviewed and updated the care records, and had planned to review other care records we did not view.
Medicine Administration Records (MAR) had not been reviewed to identify any shortfalls or errors. Guidance was not always available to staff informing them of the support the person required with their medicines. Protocols were not in place for people requiring ‘as and when needed’ medicines. There had been no harm caused to people as a result of a lack of documentation from MAR. However, without a formal auditing system in place assurances could not be given in relation to whether people had received their medicines as prescribed. We have made a recommendation about this.
Robust pre-employment checks had not been consistently followed, full employment histories for all staff had not always been obtained. The registered manager took action to address these shortfalls following the inspection. People were supported by the same core staff team, providing consistency and continuity of care. Rota’s were planned to enable staff to spend additional time with people if required.
Relatives spoke highly of staff and felt their loved one’s were safe with staff that knew their loved one well. Staff promoted people’s independence whilst respecting their privacy and dignity. Some people were supported to access the local community and take part in various activities. Staff encouraged people to make their own choices and maintain their independence. Staff would encourage and support people to help make meals if this was part of their care package. Information was provided to people in different formats relevant to their communication preference.
New staff completed an induction and worked alongside experienced staff before becoming part of the care team. Staff spoke highly of the support they received from the management team and felt there was an open culture where they were kept informed and updated.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 04 January 2018 and this was the first inspection.
Why we inspected
This was a planned inspection based on the timescales for unrated services.
We have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well-Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
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.