Archived: Human Support Group Limited - Westfields

Updated 2 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 18 and 19 October 2017 and the first day was unannounced. This meant the service did not know we were coming.

The inspection team consisted of one adult social care inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. On this occasion, the expert had experience in domiciliary care services and dementia care.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information in the PIR, along with other information we held about the service including the previous inspection report and notifications. A notification is information about important events which the service is required to send us by law.

We contacted Manchester local authority contracts and commissioning to find out what information they held on the service. Further details are contained within the report.

We spoke with nine people receiving care and one relative. We also spoke with two people who lived at the scheme but did not currently require care and one other person who had received care in the past but no longer required support as they were able to cope independently.

We spoke with nine members of staff including four care staff, the care manager and the registered manager and the area manager responsible for this scheme. We had brief interactions with the nominated individual and the group performance officer regarding the general operation of the service and quality monitoring. We also spoke with one of Anchor’s housing managers.

We looked at records relating to the service, including four support records and daily comments books, four staff personnel files, safeguarding records, minutes of meetings, and quality monitoring records.

Updated 2 December 2017

The inspection took place on 18 and 19 October 2017and the first day was unannounced. This meant the provider did not know we were coming. The service was previously inspected in June 2016 and rated ‘Requires Improvement’. At this inspection we asked the provider to ensure there was an appropriately registered manager in post and to make improvements in the use of staff’s free time, to provide more effective support to people and in monitoring the quality of the service provided. At this inspection, we noted there had been improvements in these areas. Further details of these are contained within the report.

Human Support Group Limited – Westfields (Westfields) is a domiciliary care provider registered to provide personal care support to people living within an extra care scheme. An extra care scheme is similar to sheltered housing but with additional care and support provided to meet people’s individual needs. At Westfields the housing component is separate from the care services and is provided and managed by another organisation called The Anchor Group (Anchor) who employs housing managers to take care of the premises including maintenance and gardening. In an email, the Manchester local authority commissioning team told us, “The objective of the extra care service at Westfields is to offer a ‘Home for Life’ flexible service, responsive to the changing care needs of our customers, providing support when required and at all times promoting their health, independence, welfare and human rights.”

Care staff support people living at the property in their own tenancies with a wide range of personal care needs and domestic duties, including assistance with shopping, meal preparation and home cleaning. As well as providing care to people assessed as needing it, the care team is also responsible for any identified short term care needs of anyone living at Westfields.

There are 48 apartments at Westfields and at the time of our inspection 27 people were receiving an element of personal care and support. The local authority commissions a specific number of hours for the delivery of care and support from Human Support Group Limited and these hours are distributed amongst the people identified as requiring support.

Westfields is located in the Baguley area of Manchester and has good transport links to the city centre and nearby town of Wythenshawe. Local amenities within walking distance include a supermarket, a post office, a park and leisure facilities.

At the time of this inspection, there was a manager in post who had registered with the Care Quality Commission since May 2017. The registered manager also managed another extra care scheme nearby. 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.

People told us they received care and support that was safe. Relatives we spoke with confirmed their loved ones received safe care.

People and their relatives told us staff demonstrated good hygiene practices by using personal protective equipment (PPE) such as gloves and aprons. We observed one example of unsafe practice according to current infection prevention guidance. The registered manager provided suitable assurances to address the issue immediately. We recognised that staff were aware of cross contamination and promoted good infection control in some respects, however there were areas which required further improvement. At inspection, the registered manager provided suitable assurances that this issue would be addressed in supervision and at team meetings.

There were sufficient staff deployed at Westfields to help ensure people were supported according to their needs and the provider had robust recruitment processes which helped to ensure suitable staff were employed.

Risk assessments were in place and contained sufficient details and guidance to help ensure people were supported safely.

There were suitable systems to help ensure people were protected from harm. Staff were well-informed about the types of abuse and the action they would take if they suspected that abuse was taking place. This meant people using the service were protected from harm due to organisation systems and staff knowledge.

We saw accidents and incidents were recorded and appropriate action taken to reduce the risk of any reoccurrence. The registered manager had recently implemented a separate falls monitoring system to improve management oversight of the service and help ensure incidents were managed and addressed more proactively. This meant the service had appropriate systems in place to keep people safe from harm.

There was a consistent staff team at Westfields. This meant people were supported by staff who knew and understood their needs.

Some people required support to take their medicines. Records demonstrated staff were suitably competent to carry out the task and did so safely. The service used a medication support plan and risk assessment which helped staff to support people in a safe way.

People told us staff were competent. Staff received an induction and mandatory training prior to working with people. There was evidence that staff were supported with on-going and refresher training as required. Staff received regular supervisions and appraisals to help ensure they received the necessary support to carry out their roles. Staff we spoke with confirmed this. This meant staff had the right knowledge and skills and received continuous support to function effectively in their caring role.

The registered manager had a good understanding of Mental Capacity Act 2005 (MCA) and how this legislation should be used to protect people. Staff sought people’s consent before undertaking tasks and people confirmed this was the case. Staff told us if they had concerns about people’s mental capacity they would raise this with management and also inform involved family members. The registered manager told us support from social work professionals and GPs was sought if they suspected a person lacked capacity.

Support plans indicated that consent to care had been sought appropriately. We found minor discrepancies with how consent to care was recorded which we pointed out to the registered manager. We noted however the provider had updated their documentation in this regard to better reflect that relatives had been involved in the care planning process. We concluded there was sufficient evidence to demonstrate the service had systems in place to help ensure people’s rights were protected.

There were formal systems in place to ensure staff had the skills and competencies necessary to carry out their responsibilities and that they received adequate professional support. The provider had a robust induction programme in place which was aligned to the nationally recognised care certificate induction standards. Staff also undertook training considered mandatory by the provider which included safeguarding, personal care and medication. Refresher training was scheduled to help ensure staff kept up to date with the knowledge and skills required to perform effectively in their support roles.

People told us the service supported their access to health care professionals and medical attention, if required. In the case of an emergency, medical attention was sought and relatives contacted. This meant people were supported in a proactive way to receive the right health care when they needed.

Where needed, people told us staff supported them with their food preparation. Everyone we spoke with told us they were happy with the support provided. They said staff always consulted them prior to carrying out the task and that they had a choice. This helped to ensure people maintained good nutrition and hydration.

People told us staff were kind and caring. We observed warm and caring interactions between people and the staff supporting them. These interactions extended to everyone living at the scheme and not just those receiving the regulated activity of personal care.

Staff demonstrated that they knew and understood the needs of the people they supported, as well as those living at the scheme.

People had been involved in making decisions about the support they received. Care records we reviewed confirmed this. This meant that people and their relatives, where appropriate, were included in making decisions about the support provided.

People were encouraged to develop and maintain their independence according to their abilities. This helped to ensure that they maintained a good quality of life and wellbeing.

Support plans contained personal information about people, their preferences, personal goals and how they wanted to be supported. Most care plans we looked at contained detailed descriptions of support provided to help ensure care provided was person centred.

People were engaged in activities which they enjoyed which helped to ensure improved quality of life and wellbeing.

There was an up to date complaints procedure in place and people and relatives told us they were aware of how to raise a complaint. They said any concerns they raised were resolved satisfactorily. People and their relatives were complimentary about the service and we saw several cards had been sent to the service to show their appreciation to staff and management.

People and relatives had the opportunity to provide feedback about the service provided. We noted the service had sent out customer satisfaction surveys in November 2016 and May 2017and the results of these were positive.

People told us they would recommend this service to others and some had done so.

The provider had quality assurance systems in place to monitor, for example, staff performance, support plans and medication administ