Background to this inspection
Updated
4 June 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
This inspection was carried out by one inspector.
Service and service type:
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 24 hours’ notice of the inspection site visit because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did:
Before our inspection we completed our planning document and reviewed the information we held about the service. This included notifications we had received from the provider about incidents that affect the health, safety and welfare of people supported by the service and previous inspection reports.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We also checked to see if any information concerning the care and welfare of people supported by the service had been received. We contacted the commissioning department who used Wave. This helped us to gain a balanced overview of what people experienced whilst using the service.
We spoke with a range of people about Wave. They included one person who used the service, a relative, two members of the management team and five staff.
We looked at records related to the management of the service. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead Wave in ongoing improvements. We checked care records of two people who used the service. We also looked at staffing levels, recruitment procedures and training provision.
After the inspection we continued to seek clarification from the provider to corroborate evidence found. We looked at training records.
Updated
4 June 2019
About the service:
Wave Supported Lives Ltd offers personal care only as a domiciliary care service. They support younger people living in their own home with a learning disability, physical disability or sensory impairment. The main office is based in a business park near Blackpool Airport. At the time of our inspection, the service supported five people who received a regulated activity in their own homes.
People’s experience of using this service:
We found the management team had completed extensive processes since our last inspection to enahnce safety. People and their relatives confirmed they experienced a responsive service and felt safe when staff delivered their care packages. A relative told us, “Now, I really do feel I can take a step back because I know [my relative] is safe and I can finally relax after all these years.”
The registered manager had introduced multiple documents focused on maintaining people’s safety and protecting them from inappropriate care and abuse. One staff member said, “Any concerns at all, and there have been, we are strongly advised to report.”
The management team had developed detailed, person-centred risk assessments to better support people with behaviours that challenged the service. A relative commented, “[My relative] is improving and that’s down to the staff and the care plans in place.”
The registered manager had implemented new systems to ensure they recruited staff safely and followed robust employment practices. People were supported by small staff teams to ensure they received care from regular staff who understood their needs.
Staff told us they followed procedures to ensure the safe management of medicines administration. The registered manager had worked with other healthcare professionals to develop robust protocols for people who received ‘when required’ medication.
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. A staff member said, “It is absolutley [the person’s] decision about what he wants to do. We don't use restraint, we use distraction and avoidance of triggers.”
The management team completed an initial assessment of each person’s nutritional requirements to protect them from associated risks.
Wave had a wide-ranging training programme to develop staff skills and understanding of their roles. A relative told us, “They do seem to be well-trained and they try different things to see what works and what doesn't.”
Staff demonstrated genuine affection and kindness for people they supported. One person stated, “I love the staff and they love me.” People and relatives told us the management team was highly inclusive of them in the development of their care plans.
Wave had strong leadership evidenced in the actions taken since our last inspection. The provider worked openly with people, staff and other organisations to deliver good standards of care. Staff stated they were fully involved in the ongoing development of the service and felt valued by the providers. One staff member commented, “All the managers and [the providers] are fantastic.”
The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.
The outcomes for people using the service reflected the principles and values of Registering the Right Support. We observed care practices were centred on maximising each person’s safety, independence and support. Care records included each person’s preferences and details guided staff to better understand them and how to meet their needs.
Rating at last inspection and update:
At the last inspection the service was rated requires improvement (published 25 December 2018).
Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider is no longer in breach of regulations.
Why we inspected:
This inspection was carried out to follow up action the provider told us they had taken to improve the service in all five domains.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk