Wight Home Care Limited

Wight Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults, people living with dementia, mental health impairments, physical disabilities, sensory impairment and younger adults. 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 59 people receiving personal care from the service.

People’s experience of using this service and what we found

People's care plans were up to date and contained person centred information. Risk assessments were completed for people which identified any risks, but these required further detail to ensure staff had the information they needed to mitigate risks. The provider took immediate action to make these improvements and staff demonstrated they knew people well and knew how to safely meet their needs.

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. However, some improvements were needed to the records made in relation to this.

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. The provider was meeting people’s needs in line with this guidance.

People were supported to be safe. There were systems and processes in place to ensure people were protected from the risks of avoidable harm. The provider had a policy and procedure for safeguarding adults and staff understood their responsibilities.

Staff had completed training in the safe administration of medicines and had their competency re-assessed annually or when needed. People were encouraged to maintain their independence to self-administer their own medicines, where possible. People who required support to administer medicines, were happy with how they were supported.

Staff had received appropriate training that equipped them to support people. Safe recruitment procedures were in place to help ensure only suitable staff were employed.

Staff felt they were supported by the management team and had regular contact to ensure they were informed of any important information or changes.

The management team had processes for monitoring visits and endeavoured to ensure that office staff contacted people when care staff were held up or were running late for visits.

Systems and processes were in place to monitor the service and identify and drive improvement. This included regular spot checks, audits and feedback surveys. The provider had developed an action plan to ensure they were able to identify and make any improvements needed in a timely way.

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 27 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained 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 Wight Home Care Limited 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.

Not everyone using Wight Home Care Limited received 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. This inspection was undertaken on 12 and 15 March 2018 and was announced. We gave the provider 48 hours' notice of our inspection as we needed to be sure key staff members would be available.

At the time of the inspection approximately 140 people were receiving a regulated activity from Wight Home Care Limited.

At the last inspection we rated the service good. At this inspection the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

A registered manager was in post. 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.

We received positive feedback from people about the service. People who used the service expressed satisfaction about care staff, office staff and the management team. All the people and family members who were asked if they would recommend the service to others said they would.

People and their families told us they felt safe. Staff understood their safeguarding responsibilities and knew how to prevent, identify and report abuse. Risks relating to the health and support needs of the people and the environment in which they lived were assessed and managed effectively. There were safe medication administration systems in place and people received their medicines when required.

Safe recruitment practices were followed and appropriate checks were undertaken, which helped make sure only suitable staff were employed to care for people in their own homes. There were sufficient numbers of care staff to maintain the schedule of visits.

The provider and staff understood their responsibilities to protect people from the risk of infection. There was an infection control policy in place which was followed by staff and staff undertook training in this area.

Staff completed an induction programme and were appropriately supported in their work by the management team. People and their families described the staff as being well trained and they were confident in the staff’s abilities. The provider has a robust training system in place and all staff had received training as required.

Staff and the management team, knew how legislation designed to protect people's rights affected their work. They always asked for consent from people before providing care.

Where people required support with eating, drinking or meal preparation this was provided. Care plans contained information about any special diets people required, food preferences and support needs and staff were aware of people's dietary needs.

People who used the service felt they were treated with kindness and said their privacy and dignity was respected. Staff knew the people they provided care to well and understood their physical and social needs. Staff were able to describe how to meet people’s needs effectively. Staff understood people’s healthcare needs and people were supported to access healthcare professionals when needed.

People were supported to use technology and specialist equipment to meet their care needs and to support their independence where appropriate.

People and, when appropriate, their families were involved in discussions about their care planning and given the opportunity to provide feedback on the service. They were also supported to raise complaints should they wish to.

At the time of the inspection no one using the service was receiving end of life care. However the registered manager assured us that people would be supported to receive a comfortable, dignified and pain-free death.

The managing director was fully engaged in the running of the service. People, their relative and staff members told us they felt the service was well-led. The culture of the service was open and transparent. Staff felt supported and valued for the work they did. The provider had a range of quality monitoring systems in place and the management team aimed to continuously improve the quality of the service they provided.

Care plans and risk assessments were in place and these were reviewed regularly. Care was planned and discussed with people who received the service. One person said 'I have got a care plan and every now and then my Care Co-ordinator comes and we'go through everything". Another commented 'I have a care plan and they show it to me so I know what is going on". People told us they got to know their carers well and they were informed if carers were running late or there was a change to their regular carer.

People said they felt safe with care staff. One person said 'I know them all and trust them like my own family". The service had a policy for safeguarding vulnerable adults and staff we spoke with were familiar with this.

Systems were in place to induct and train staff and we saw evidence these were up to date. Spot checks and supervision were regularly carried out to ensure quality of care. Quality assurance procedures were in place, including consultation with people who used the service or their relatives. People using the service and staff were confident that concerns reported to the manager were acted on quickly. This meant people using the service and staff could influence the service provided by the agency.

We looked at six care plans which contained detailed information about the care, treatment and support that was required. People told us that staff were able to meet their needs and were very reliable.

We spoke to two community health professionals who told us they had a good working relationship with the service. One said, 'All their staff are professional and competent, and I've been really impressed with some who go above and beyond what can be expected'.

Staff were appropriately trained in relation to medication, and supported people by prompting them to take their medication at the right times. The provider had recently moved to new offices and had extended their training facilities, which allowed the provider to continue to deliver training on the premises.

Staff were encouraged and supported to gain further qualifications. Arrangements for supervision were in place, and the provider was introducing a system of appraisal for all staff. The quality of service provision was monitored in a number of ways, and improvements had been made as a result.