Archived: Sagecare (Wigan)

Sagecare (Wigan) is a domiciliary care agency, providing personal care to 271 older people and children living in their own homes in the Standish area of Wigan. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects services where people receive personal care. They receive help with tasks related to personal hygiene and eating; we also consider any wider social care provided.

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

Since the previous inspection, improvements had been made to recruitment systems and the staff files now included all required documentation. There were still some issues with staffing levels at weekends, but the service managed to cover the calls and was continuing to recruit more staff to address this. The registered manager had implemented regular one to one supervisions and staff were now having these on a regular basis. Training and development needs were identified and all required training had been completed by staff and refreshers were on-going.

The service had systems in place to help safeguard people from abuse and staff had completed appropriate training. People told us they felt safe with the care staff who visited. Individual risks were thoroughly assessed and managed by the service. Medicines were managed safely. Staff were aware of the processes to prevent and control the spread of infection. All staff were following the guidelines in place due to COVID-19.

People’s care needs were thoroughly assessed and their care plans included relevant health and personal information. People’s individual needs, preferences and choices were taken on board. The service supported people to maintain a healthy and nutritious diet and worked with other agencies to ensure good, joined up care.

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.

The management team demonstrated an understanding of quality assurance and regulatory requirements. The service engaged with people via telephone reviews and quality monitoring.

The service took learning and improvement from the results of audits, which were undertaken regularly. Complaints were dealt with in a timely and appropriate way and the service had received a number of compliments.

Staff felt the management team were supportive and communication was effective. Observations of staff practice were now being completed regularly. Staff spoke positively about their roles and felt morale had improved due to the new management structure.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 4 March 2020) and there were two breaches 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 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, Effective and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. 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 Sagecare (Wigan) on our website at www.cqc.org.uk.

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.

Sagecare (Wigan) is a domiciliary care agency, providing personal care to 309 older people and children living in their own homes in the Standish area of Wigan. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects services where people receive personal care. They receive help with tasks related to personal hygiene and eating; we also consider any wider social care provided.

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

Quality assurance processes and systems measures were in place however these were not always effectively used. We found several areas of improvement throughout the inspection that the provider had not addressed. The quality and safety of care that was delivered was not always monitored and reviewed.

We received mixed feedback about the skills, experience and abilities of Sagecare (Wigan) staff. Although all staff had completed a period of ‘induction’ and were provided with training opportunities, feedback suggested that further training and development was required. Staff were also not receiving routine supervision or appraisals.

Staffing levels and recruitment had been an area of concern for the provider. A recruitment drive was under way and new employees were in the process of being recruited. Although staffing levels had started to improve, we received mixed feedback about continuity and punctuality of staff. We have made a recommendation staffing and recruitment.

The registered provider had an up to date complaints policy in place; however, the feedback we received suggested that verbal complaints were not always effectively responded to. People were provided with complaint process information and knew who to contact to make a complaint.

We received a number of concerns in relation to medication administration support that Sagecare (Wigan) staff offered. Medication policies and procedures were in place and staff received the necessary training. The registered and regional manager confirmed that a number of medication errors had occurred, investigations took place and measures were implemented to mitigate future risk.

A person-centred approach to care was provided, care records contained tailored information that staff could familiarise themselves with. People told us that routine staff were familiar with their support needs, however continuity of care was not always provided, particularly of a weekend.

People's support needs and level of risk were as assessed and monitored from the outset. A new digital platform ensured that staff had access to up to date support plans and risk assessments for each person receiving support.

Staff were familiar with safeguarding and whistleblowing procedures. Staff received training in this area of care and understood the importance of keeping people safe. The provider submitted all necessary safeguarding incidents to the Local Authority and CQC accordingly.

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.

We received largely positive feedback in relation to the care and support Sagecare (Wigan) staff provided. One person told us “The staff are brilliant, I cannot fault them.” Staff provided respectful, dignified and compassionate care.

Rating at last inspection:

The last rating for this service was ‘good’ (published 8 September 2017). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected:

This was a planned comprehensive inspection as part of CQC’s inspection schedule.

Enforcement

We identified breaches of regulation in relation to ‘staffing’ and ‘good governance’. Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.