Wise Home Care Services

At the time of the inspection, the location did not support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Wise Home Care Services Ltd is a domiciliary care agency that provides care and support to people in their own home. People receiving a service included those with dementia, mental health and physical disabilities. There were 3 people receiving care and support at the time of the inspection.

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

Right Support

People's needs, preferences and wishes were met by a dedicated care staff team who knew the people they cared for well. People were supported in a way which promoted safety. Risk assessments were in place and reflected people's current 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.

Right Care

People were protected from the risks of harm, abuse or discrimination because care staff knew what actions they should take if they identified concerns. There were enough staff, who had been safely recruited, working to provide the support people needed, at times of their choice. People received kind and compassionate care. Care staff protected and respected people's privacy and dignity and understood and responded to people's individual needs.

Right Culture

The registered manager and staff promoted a caring culture, where providing person centred care was the focus of the service. Staff turnover was low, which supported people to receive consistent care from staff who knew them well. People were asked to provide feedback on the care provided and they had confidence in the registered manager to deal with concerns appropriately. Care staff felt supported in their roles and were provided with the opportunity to discuss any issues which they may have in an open and inclusive way.

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 11 June 2021). Breaches of legal requirements were found.

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 29 April 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, person centred care and good governance.

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, Responsive and Well-led which contain those requirements.

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 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 Wise Home Care Services Ltd 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.

Wise Home Care Services is a domiciliary care agency that provides care and support to people in their own home. People receiving a service included those with dementia, mental health, physical disabilities and learning disabilities. 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 visit the service was providing regulated activity to two people.

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

The provider needed to improve the governance of the service and introduce systems and processes around the monitoring of the service delivery. This was to ensure the regulated activity was provided effectively, safely and in line with the current national guidelines.

We identified several shortfalls in how the service was run. These related to the lack of adequate assessment of people’s care needs and preferences, and risks associated with providing the regulated activity. Further shortfalls concerned unsafe management of medicines, limited arrangements around infection prevention and control and the lack of required staff training.

Although we identified shortfalls, we noted that relatives spoke positively about the care provided by the service. They thought the staff were kind and caring and the manager was approachable and supportive.

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.

This service partially demonstrated how they were meeting the underpinning principles of Right support, right care, and the right culture.

Right care:

We could not always ascertain if the care provided was fully person-centred as there were gaps in the process of assessing people’s needs and preferences. However, based on the feedback of relatives and care staff, the provider promoted people’s dignity, privacy and human rights.

Right support:

Staff told us when providing care, they always maximised people’s choice, control and independence.

Right culture:

Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. Staff spoke kindly about the people they supported. Staff said their main aim was to provide good care to people, which helped people to feel good about themselves.

Staff were sensitive to cultural and personal preferences and were willing to adhere to them when providing support to people.

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 22/03/2019 and this is the first inspection.

Why we inspected

We inspected Wise Home Care Services as part of our inspection prioritisation programme. We carried this inspection as we had not inspected this location since it was registered with us in March 2019. We needed to carry out a comprehensive inspection to take an in-depth and holistic view across the whole service, looking at all five key questions to consider if the service is safe, effective, caring, responsive and well-led.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, 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.

Enforcement

We have identified breaches in relation to risk assessment process, infection control, management of medicines, assessment of needs and preferences, at this inspection. We made two recommendations about recruitment and providing joined-up care.

We issued the warning notice about Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 18 (Staffing). Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.