About the service: City Care Welwyn Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection, the service was providing personal care to 52 people. People’s experience of using this service:
¿ At the last inspection on 30 June 2016 we identified people had not signed to give consent to care and treatment, risks associated with the support people received were identified by staff and effectively mitigated, however these were not evidenced in people`s plan of care; and audits had not been always as effective. At this inspection on 7 and 8 March 2019 we identified the registered manager had made improvements to all areas and we were satisfied with their response.
¿ People continued to be safe as risk management plans identified known risks and gave staff clear guidance on how to mitigate those risks. Staff had sufficient understanding of how to identify, respond to and escalate suspected abuse. Staff received on-going safeguarding training.
¿ People’s medicines were managed safely and administered as intended by the prescribing Pharmacist. Medicines were regularly audited to ensure any errors were identified quickly and action taken to minimise the negative impact on people.
¿ The registered manager deployed sufficient numbers of suitable staff to keep people safe. Staffing levels were adequate and people confirmed staff had sufficient time to sit and talk with them.
¿ People continued to be supported by staff that received regular training to enhance their skills and experience. Through regular supervisions and spot checks, staff reflected on their working practices.
¿ Staff were knowledgeable about and adhered to the principles of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards. People’s consent to care and treatment was sought, documented and respected.
¿ People were supported to access food and drink that met their dietary needs and preferences where agreed in their care package. Where there were concerns about people’s health and well-being referrals were made to healthcare professionals and advice given implemented into the delivery of care.
¿ People continued to be supported by staff that encouraged their independence, treated them equally and with kindness and compassion. People’s dependency levels were regularly reviewed and support provided to reflect people’s current needs.
¿ Care plans were person centred and gave staff clear guidance on the support people required in line with their wishes and preferences. Care plans were reviewed regularly and where possible people and their relatives were encouraged to develop these.
¿ People were able to raise concerns and complaints and there were systems and processes in place to ensure complaints were managed responsively and in a timely manner.
¿ People, their relatives and staff spoke positively about the registered manager. People and staff confirmed the management structure at the service was effective. People’s views were regularly sought to drive improvements. An external organisation carried out a comprehensive quality monitoring process, to gather people’s views. Issues identified were acted on in a timely manner.
¿ The registered manager carried out regular audits of the service to monitor the service provision. Issues identified during the audits were acted on swiftly and lessons learnt to minimise the risk of repeat incidents.
¿ The registered manager continued to encourage partnership working with other stakeholders and healthcare professionals.
Rating at last inspection: The service was previously inspected on 30 June 2016 and was given an overall rating of Good. We gave the service a rating of Requires Improvement in the key question, is the service well-led?
Why we inspected: This was a planned inspection in line with our inspection programme.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received, we may inspect the service sooner.