15 September 2017
During a routine inspection
Walsingham West Cumbria Domiciliary Care provides packages of care to people with learning disability who live in their own properties in the community. Some people live in shared houses in schemes called 'supported living' and other people live alone with support. When we visited there were twenty seven properties where thirty nine people were supported by the service provider. Walsingham provides residential accommodation and community support throughout England. This service delivery was based in an office in Workington.
The service employed a registered manager who was suitably qualified and experienced in managing a domiciliary care 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
A number of changes had been put in place since the registered manager took over the service. The auditing of records was done in detail, people given the opportunity to voice their opinions and action taken when things needed to improve. We saw that talking with people and with staff, checking audits and analysing incidents had led to new focus groups, changes to management work patterns, changes to care planning and new ways of supporting people with medicines. Discussions were being held on introducing assistive technology that would help people live more independently.
We also noted that the provider had identified the lack of good quality properties to rent. They had purchased a number of properties which a different company ran for the tenants. This meant that people had moved to more appropriate environments. We saw that this had made significant changes to a number of people who were now living more independently.
Suitable risk assessments were in place. There had been no reportable accidents or incidents in the service but staff understood how to deal with any issues.
Good arrangements were in place to ensure that new staff were recruited appropriately. Established staff were monitored and any problems of care delivery were dealt with through supervision or disciplinary actions.
People had their medicines reviewed on a regular basis and quality systems were in place to ensure that staff understood how to administer medicines. Staff had received suitable training. Errors were dealt with appropriately.
Staff were aware of how to prevent cross infection and the provider had suitable policies and procedures in place
Staff were given suitable levels of training and support to ensure that each of them were helped to develop in their role. Staff received regular supervision, their practice was observed and they had annual appraisals.
The registered manager understood her responsibilities under the Mental Capacity Act 2005 and was aware of how this applied to people living in their own properties. Some people in the service did have their liberty restricted for their safety. This was done legally and in the least restrictive way possible. 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.
People were supported to access health care and to follow healthy eating and exercise so that they could stay as well as possible. Staff gave people a lot of support to help them to maintain a healthy weight.
The registered manager was working with the landlord of the main office as people who used services wanted improvements to disabled access. She was also helping people to talk to their landlord about some problems in two supported living settings.
We met very caring and committed staff members who could communicate well with the people they supported. Staff understood the needs of the people they supported and they encouraged them to have meaningful lives. People were encouraged to be as independent as possible.
Good assessment of need was in place. Staff worked with health and social care professionals to understand what people needed and wanted. They did, however, focus on the person themselves and all care plans were written positively and with a person centred approach.
People were supported to follow their own interests, activities and hobbies. They also had the opportunity to socialise with other people that Walsingham supported.