Westhome Care Services Limited

Updated 12 February 2019

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.

This inspection site visit took place on 21 November and 30 November 2018 and was unannounced. Inspection site visit activity started on 21 November 2018 and ended on 30 November 2018. It included reviewing documentation and speaking to staff and relatives via telephone interviews. We visited the office location on 21 and 30 November 2018 to see the registered manager and office staff; and to review care records and policies and procedures.

The inspection was carried out by one 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.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they play to make. We also reviewed the information that we held about the service. This included any statutory notifications received. Statutory notifications are specific pieces of information about events that happen within the service, which the provider is required to send to us by law.

We sought feedback from the local authority contracts monitoring and safeguarding adults’ teams, and reviewed the information they provided. We contacted the NHS Clinical Commission Group (CCG), who commission services from the provider. We also contacted Healthwatch, who are the independent consumer champion for people who use health and social care services. We used the feedback gathered from these parties to inform our inspection and judgements.

During the inspection, we spoke with nine people who used the service, 18 relatives and seven members of staff including the registered manager, nominated individual and a director of the service. We reviewed the care records for six people receiving the related activity and the recruitment records for two members of staff. We reviewed policies, procedures, audits and records relating to how the service is ran.

Updated 12 February 2019

We carried out an unannounced comprehensive inspection of Westhome Care Services Limited on 21, 23, 26, 29 and 30 November 2018. At the last comprehensive inspection of the service on 24 and 27 July 2017, 24 August 2017 and 29 September 2017 breaches of legal requirements were found in relation to the person-centred care, safe care and treatment of people and the governance of the service. At this inspection the service had made the required improvements and was meeting the legal requirements.

Following the last comprehensive inspection, we asked the service to complete an action plan detailing what they would do and by when to improve the key questions of safe, caring, responsive and well-led to at least good. We saw people’s needs had been assessed regularly and these were detailed in care plans. Infection control procedures were now in place at the service and the service had a policy for staff around this. The governance of the service had improved and we saw evidence of a new governance frame work which included regular audits and documented actions taken if any issues were highlighted.

Westhome Care Services Limited is a domiciliary care agency. It provides personal care and support to people living in their own homes. It provides a service to a range of people including those living with mental health needs, dementia and physical disabilities. At the time of inspection there were 97 people using the service and 84 were receiving the regulated activity of personal care.

There was a registered manager in post who had been registered with the Care Quality Commission (CQC) to provide the regulated activity since March 2016. A registered manager is a person who has registered with the CQC 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. The registered manager submitted notifications to the Commission but we found two incidents that had not been notified to the CQC.

There was a new governance framework in place to monitor the quality and safety of the care provided to people. At the time of inspection this framework had not been fully imbedded and not all audits had been completed.

People told us that they felt safe with the care provided by staff and relatives agreed with these comments. We found there were policies and procedures in place to help keep people safe. Care files contained detailed risk assessments which were personalised, these included steps to mitigate risks around infection control, environmental risks and people’s risk of having a fall. Staff had received training and attended supervision sessions around safeguarding vulnerable adults.

Medicines were managed safely. Staff had received training around medicine’s management and had regular checks of their competencies.

Staff were safely recruited and they were provided with all the necessary induction training required for their role. The registered manager continued to provide on-going training for staff and monitored when refresher training was required. The registered manager had previous experience in a training role and delivered face to face training with all staff in a designated training room at the service’s main office. Accidents and incidents were recorded correctly and if any actions were required, they were acted upon and documented. There was an infection control policy in place and staff had received training in this.

Staffing levels reflected the needs of people using the service and visits were appropriately scheduled to meet people’s needs. Staff received regular supervision and appraisals.

The service had carried out an extensive service user quality project to ensure that the service was performing to a high standard. This included collating feedback and survey information. People and their relatives told us that they felt staff were caring and kind. People were supported to maintain social relationships and were supported to attend activities that they had chosen in the community. People told us that staff were caring and respectful whilst carrying out personal care. Staff demonstrated a good knowledge of people and their relatives, what people liked and disliked and the best way to support each person.

There was a complaints procedure in place and people were provided with this when joining the service. Complaints received were investigated fully and outcomes shared with people, staff and their relatives. People and their relatives told us that they felt confident in raising a complaint and who they would contact. One person was accessing an advocacy service and the service worked with them to support this..