Wideway Care Limited

Wide Way Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older 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.

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

There were systems were to ensure people were protected from risk of harm. The registered manager and staff were aware of procedures to follow to safeguard people. Records were in place to monitor any specific areas where people were more at risk and explained what action staff needed to take to protect them. There were enough staff to meet people’s needs and the recruitment procedures were robust. The service had an efficient system to manage accidents and incidents and learn from them so they were less likely to happen again. Medicines were well managed on people’s behalf. There were systems in place for the monitoring and prevention of infections.

Staff received appropriate training, support and development which enabled them to meet people’s needs effectively. They had opportunities on a regular basis to discuss their learning and development through one-to-one meeting with the registered manager. Staff supported people in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice. People were supported by staff and external health professionals to maintain their health and wellbeing.

People received care and support in accordance with their preferences, interests and diverse needs. They were involved in the planning of their care. There was a complaints procedure in place and people knew how to make a complaint. People had the privacy they needed and were treated with dignity and respect at all times. They were supported to be as independence as possible.

There was an open and inclusive culture in the service, with staff, people, relatives and other external professionals encouraged to help improve the service provided to people. There were effective procedures in place to monitor the quality of the service and where issues were identified action was taken to address these to promote continuous improvement. Regular audits and checks took place. The service worked in partnership with other organisations to support and care for people.

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 the service was requires improvement (published on 28 September 2019) and there were breaches of Regulation 9 (person centred care), Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 18 (staffing). 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

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Wide Way Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults. At the time of the inspection there were three people receiving personal care from the service.

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

People and their relatives told us they were not always involved in the planning and review of their care and support. People’s preferences and changing needs were not reviewed and documented by the service. The service did not follow up on identified risks for people using the service and clear records were not maintained. Medicines were not always administered safely and staff competency to administer medicines was not checked. People were protected from the risk of infection. The service had safe staff recruitment practices. Staff demonstrated an understanding of safeguarding. However, some staff were unsure of the process for whistleblowing. We have made a recommendation about whistleblowing processes.

People and their relatives felt staff knew them well and were happy with the approach and interactions with the care staff. People and their relatives told us they were treated with dignity and privacy was respected. However, the provider did not seek feedback from people or their relatives about the quality of the service. Staff supported people and showed an understanding of equality and diversity. We have made a recommendation about accessible information formats.

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. However, this was not always documented in people’s care records. Staff received training to support people and to meet their needs, however this training was not always reviewed in a timely manner. Staff did not have regular supervision meetings with the management team to identify any training or development needs. Staff supported people to eat and drink enough to meet their needs.

People told us they knew how to complain about the service and would do so if necessary. People were supported to maintain good health. The provider worked with health professionals to ensure people received health care.

The provider did not have robust systems in place to monitor the quality of the service provided. We found up to date records were not kept regarding quality checks or improvements made to the service. The service did not record how they learned from accidents and incidents and did not notify the Care Quality Commission of such events, as they are required to do. We have made a recommendation about systems for processing notifications.

The management team and staff worked together well. Staff told us the management team were approachable. Staff were supported outside of working hours and confirm the management team was available.

This service was last inspected in June 2013. We did not give a rating but found they met the regulations we inspected.

Why we inspected

This was a planned inspection.

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

We have identified breaches in relation to risk assessments and medicines, person centred care, staff training and governance of the service at this inspection.

Enforcement

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

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

People who used the service told us that they felt safe at the home and were well looked after. One person we spoke with said, "my carers are alright, they do everything for me that I ask of them. I have no complaints. If I have any concerns they listen to me."

There were effective recruitment and selection processes in place. We found that people were cared for and supported by, suitably qualified, skilled and experienced staff.

The person's relative was mostly positive about the care and support the person received from their regular care workers. They told us, 'the carers always show up and do what's needed.'

Care records were drawn up and reviewed with people or their relatives. The care plan we saw was reviewed and updated in November 2012. However, there was not enough details about the care and support the person required.

The agency's procedures for safeguarding adults were not effective and incidents that placed people at risk were not reported to the local authority's safeguarding adults team.

Staff recruitment procedures were not effective and checks were not carried out on staff before they worked with people. This meant that people might be cared for by staff who were not suitable.

There was a lack of evidence that staff received all the training they needed to make sure they were appropriately supported to do their work.

There was a written policy and procedures for responding to complaints but some of the information was out of date.