Archived: Westminster Homecare - Sheffield

Updated 7 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

Inspection activity commenced on 1 February 2018 with telephone calls to people and ended on 9 March 2018. We visited the office location on 5 and 9 March 2018. The visit was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to make sure the registered manager was available and arrange visits to people in their own homes. The membership of the inspection team was one adult social care inspector, a bank inspector, an assistant inspector and two experts 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.

Before our inspection, we reviewed the information we held about the service and the registered provider, such as notifications of safeguarding and incidents. Notifications are changes, events or incidents the registered provider is legally obliged to send us within required timescales. This helped to inform us what areas we would focus on as part of our inspection. We also contacted the local authority to ask them about information they were able to share with us in respect of the commissioning and contracting arrangements.

We used a number of different methods to help us understand the experiences of people who used the service. We spoke with 15 people receiving a service, and four of their relatives by telephone. We also visited four people who received a service in their own homes. During the course of the inspection we spoke with 15 staff, including care staff and staff working in the office. At the office we also spoke with the registered manager, the national quality manager and the operations manager. We reviewed a range of records including 14 people’s care records, medication administration records (MARs), six staff files and other records relating to the management of the service such as complaints, staff rotas, staff training and supervision.

Updated 7 July 2018

This inspection took place on 5 and 9 March 2018 and was announced. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to older and younger adults, children, people living with dementia, people with a learning disability and people with mental health needs.

At our last inspection on 29 March and 3 April 2017, we found continued breaches in four regulations of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014: Regulation 9, Person-centred care, Regulation 12, Safe care and treatment, Regulation 13, Safeguarding service users from abuse and improper treatment and Regulation 17, Good governance. We also found an additional breach in Regulation 16, Receiving and acting on complaints. We issued warning notices for regulations 9, 12 and 17 and requirement notices for regulations 13 and 16.

Following our last inspection, we met with the registered provider to confirm what they would do and by to make improvements at the service.

This inspection was undertaken to check that the service had made improvements and to confirm that they now met all of the legal requirements. At this inspection, we found sufficient improvements had not been made to meet all those legal requirements.

There was a manager registered with the Care Quality Commission for the service. 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. This was a different manager than at the last inspection.

We found some improvements in responding, recording and taking action to minimise risk. However, further improvement was required, so that all people were supported to stay safe and have their nutritional and healthcare needs met.

We found some improvements in the systems and processes in place to support the safe management of medicines, so that concerns with medicines were being identified and action taken to minimise further concerns. However, further improvement was required so that the proper and safe management of medicines was in place for all people.

We continued to receive mixed views regarding consistency of staff, call times and the length of calls.

The service had a process in place to listen and respond to people’s concerns and complaints. Improvement was required to resolve the root cause of the complaint to minimise the risk of reoccurring complaints.

We found improvements to the systems and processes the service used to monitor risks and people’s satisfaction at the service, and compliance with regulations. Whilst these showed improvements, further improvement was necessary to ensure compliance with regulations.

Systems and processes were in place to protect people from abuse and avoidable harm, including the management of financial transactions.

When staff were recruited, a system was in place so that the relevant information and documents were obtained. The service had systems and processes in place to provide training, supervision and appraisal for staff so that they had the skills, knowledge and experience to deliver effective care and support.

People were treated with compassion, kindness, dignity and respect.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, improving records and staff knowledge in the subject of MCA would better evidence this.

The inspection found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.