Worth Valley Care Services Ltd

Updated 22 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors, an assistant 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 13 April and ended on 20 April 2023. We visited the location’s office on 13 April 2023.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 18 January 2023 to help plan the inspection and inform our judgements. We sought feedback from the local authority who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 9 relatives about their experience of the care provided. We spoke with 9 members of staff including the registered manager, office manager and care staff. We reviewed a range of records. This included 6 peoples care records and medication records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 22 June 2023

About the service

Worth Valley Care Services is a domiciliary care service that provides care and support for people in their own homes. At the time of our inspection 58 people received personal care. 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.

The service supported adults including people living with dementia, physical disabilities, mental health conditions, learning disabilities and autistic people.

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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

Right Support: Risks to people were not always well managed. People’s care records needed to be more detailed and accurate to ensure staff provided the right support. People were happy with the care and support they received. People were supported by a regular team of staff who knew them well. This promoted continuity of care. Staff worked in partnership with people, relatives and health and social care professionals to provide good outcomes for people.

Right Care: Staff were not always recruited safely. People’s needs and preferences were not always thoroughly assessed. People’s care records did not contain the information staff required to deliver safe and personalised care. People told us they felt safe with staff and were complimentary of the care they received. People received consistent care from staff who knew them well. People and those important to them were involved in planning their care. Staff understood how to protect people from abuse. There were enough staff to meet people’s needs and deliver consistent care.

Right Culture: Quality assurance and monitoring systems needed to be improved. The provider needed to improve their audit processes to learn lessons, reduce risk and improve the quality of care people received. Improvements were required to ensure medicines and risks to people’s health and wellbeing were safely managed. The registered manager was passionate about the service and promoted an inclusive, open and person-centred culture. The care team listened and responded to people's views.

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

Rating at last inspection

The last rating for this service was good (published 31 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this report. You can see what action we have asked the provider to take at the end of this full report.

We saw no evidence that people using the service were harmed as a result of the risks identified. Following the inspection the provider sent us an action plan and assured us they would take action to mitigate the risks to people and ensure appropriate improvements were made. They also confirmed they were not taking new care packages to enable staff to focus on making the required improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Worth Valley Care Services on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, good governance and staff recruitment.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an updated action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.