Westmorland Homecare - Kendal

Updated 2 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 took place between 21 November & 3 December 2018 and was announced. This was to ensure someone would be available at the office to speak with and show us records. An adult social care inspector and an Expert by Experience formed the inspection team. 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 visited the office on the 22 & 23 November and carried out telephone interviews between 21 November and 3 December. We spoke with 10 people who used the service and four family members at a day service. The Expert by Experience spoke with 15 people and five of their family members by telephone. We spoke with the registered manager, senior care coordinators, human recourses (HR) manager, scheduling coordinators and training coordinators, and with six care staff; and observed staff meetings. We checked the care records of six people who used the service and the files for six members of staff. We looked at key policies and procedures and the systems for managing the service.

Before we visited the service we checked the information we held about this location and the service provider, for example, inspection history, statutory notifications and complaints. A notification is information about important events which the service is required to send to us by law. We contacted professionals involved in caring for people who used the service, including commissioners and safeguarding staff.

We used information the provider sent us in the Provider Information Return (PIR). 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 plan to make. We had the latest provider survey from people using the service and their relatives; 92 surveys were sent out 56 were returned. This gave a 61% response rate.

All this information was used in a planning tool to inform the inspection process.

Updated 2 February 2019

The inspection took place between 21 November and 3 December 2018 and was announced. We gave the provider 48 hours’ notice because the service is a domiciliary care agency and we wanted to make sure someone would be at the office to assist with the inspection.

Westmorland Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to mostly older adults. Not everyone using the service receives the regulated activity personal care. The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care such as help with tasks relating to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

At the time of this inspection, the service provided personal care to 96 people. The majority of the people that received care from the provider had made the choice to use the service as it was either privately funded or through the use of their direct payments. A small number of people were funded through adult social care or by NHS continuing healthcare funding.

The service registered with CQC in October 2017. This is the first inspection of the service.

The service had a registered manager who was also the nominated individual. 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 service was owned and run by three directors; two were medically trained and experienced doctors. One had previous experience of being the registered manager of a domiciliary care agency that had been rated as outstanding.

People and relatives were extremely positive about the caring nature of staff and the responsiveness and reliability of the service. Everyone we spoke to, without exception, told us how the service exceled in delivering a service that met their needs. One person told us, “They are passionate about giving great service and being the best carers. It’s the whole package, they do everything right."

People were supported to continue to live independently within the community and through positive risk taking so that people could live fulfilling lives whilst still remaining safe. The service had set up a contract with an independent physiotherapist to help people maintain and regain skills to ensure they remained safe in their own homes.

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. Staff were skilled and proactive in recognising and reducing risks.

Reliability had been a key factor in people rating this service so highly. The service had an unbroken track record of no missed visits and guaranteed that no one would receive a visit from a care worker they had not met before. People told us they had a set team of care staff and that this was extremely important to feeling safe and well cared for.

Safeguarding had a high profile in the organisation and staff were highly skilled and trained in protecting vulnerable adults from abuse. The service had developed innovative training using drama students to act out scenarios to make the safeguarding training for staff come to life and to be more meaningful.

Staff were highly motivated and reflected pride in their work. The values and culture of the service was exemplified by all the staff who worked in the service. People using the service used the term "go the extra mile" frequently to described staff support. Staff recruitment was robust and the selection process very competitive to ensure that staff had the right attributes, skills and experience.

A well-structured staff development programme resulted in a professional and highly-skilled workforce. The agency’s own health and social care staff training academy had won regional and national awards and recognition. People and their relatives could access this training if they wished, and many described ‘feeling part of the team’.

The service saw people as partners and they were consulted, listened to and valued. Staff used inclusive ways of communicating with people so they were supported to take ownership of their care. People were supported to be part of interview panels for new staff and to take part in the running of the service, such as through the provider's monthly Quality and Governance and Engagements meetings.

Healthcare professionals were highly complimentary of the service offered to people. Commenting on how well people’s conditions were monitored, the skills of the staff team and how well the service communicated and linked with other services. One healthcare professional described the agency as "Leaders in their field, proactively changing the face of how social and healthcare is delivered."

The agency had pro-actively worked in partnership with local professionals and other organisations to improve the health and wellbeing of local people. The provider had led projects for more effective and safer hospital discharges for people by working with the hospital wards and community professionals.

The service was exceptionally well-led and had excellent links with the local community. They were proving to be a leader in the field and had won national and regional awards and recognition for their care, training and health projects.

There was a strong emphasis on continually striving to improve the quality and safety of the service and ensure that people were receiving excellent outcomes. Quality systems and checks were highly developed and were part and parcel of the working practices within the organisation.