Archived: Westminster Homecare Limited (Ipswich)

Westminster Homecare Limited (Ipswich) is a domiciliary care service providing personal care to people living in their own homes. 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. At the time of our inspection there were 39 people using the personal care service.

At the time of the inspection, the location did not provide personal care support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

Right Support: People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: People’s care plans reflected the individual needs people required and guided staff in how people’s needs, preferences and rights, for example privacy and independence, were met.

Right Culture: People told us the staff who supported them were caring and compassionate.

There were systems in place to provide people with a safe service. This included safe recruitment, management of medicines and the assessment and mitigation of risk. Ongoing recruitment reduced the risks of missed visits, the system in place supported the management team to identify associated risks and address them. Staff had access to personal protective equipment (PPE) and had been trained in infection control. Where we had received feedback about concerns about infection control, the management team took immediate action.

Since our last inspection there had been a change in leadership. People using the service and staff were updated about the changes at the time. There was a range of audits and monitoring systems in place to assist the management team to identify any shortfalls and address them. People were asked for their views about the service they received and these were used to drive improvement, for example updating people’s care plans where required.

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 4 March 2020).

Why we inspected

The inspection was prompted in part due to concerns received about missed visits and care plans being out of date. A decision was made for us to inspect and examine those risks. There had been a recent change in management in the service, we wanted to be assured of the governance and leadership in the 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.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report. The overall rating for the service has not changed and remains good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westminster Homecare Limited (Ipswich) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Westminster Homecare Limited s a domiciliary care service providing personal care to people living in their own homes in Ipswich and surrounding areas. 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. At the time of inspection, the service was providing personal care to 50 people.

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

People and relatives were satisfied with the care provided by Westminster Homecare Limited which they described as good and met their individual needs. They were involved in making decisions about their care and told us they felt comfortable in the company of the staff who knew them well and were kind and friendly. Most said they would recommend the service, and several had.

Where people required support with their dietary needs, health and with their medicines, this was done safely. Infection control processes protected people from the risks of cross infection.

There were enough staff safely recruited, trained and supported appropriately to cover the planned visits to people. Staff understood how to protect and safeguard people. Risks to people were assessed and mitigated, which reduced the risk of harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Systems to monitor the quality and safety of service were in place. People were asked for their views and their feedback used to improve the service and make any necessary changes.

Rating at last inspection

The last rating for this service was Good (published 4 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

At the last inspection of 16 February 2015 the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager in post. 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.

There were systems in place which provided guidance for care workers on how to safeguard the people who used the service from the potential risk of abuse. Care workers understood their roles and responsibilities in keeping people safe. Where safeguarding issues had arisen the service learned from these and used their learning to improve the service and reduce the risks of incidents happening again.

There were processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised. Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

Care workers were available to ensure that planned visits to people were completed. People were supported by care workers who were trained and supported to meet their needs. Where people required assistance with their dietary needs there were systems in place to provide this support safely. Where required, people were provided support to access health care professionals.

Care workers had good relationships with people who used the service. People were involved in making decisions about their care and support. People received care and support which was planned and delivered to meet their specific needs.

The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve. A complaints procedure was in place.

Further information is in the detailed findings below.

There is a current investigation ongoing. Once we receive the outcomes of this we will consider our regulatory response and report on it, if required.

Our last inspection of 25 July 2013 found that the provider was not meeting the standards for Regulation 13, outcome 9. This was because the service did not protect people against the risks associated with the unsafe use and management of medication by way of appropriate arrangements for the administration recording of medicines. The provider wrote to us to tell us the actions they had taken to address the shortfalls. We undertook a follow up inspection 27 September 2013 to check that the improvements had been made. We looked at records associated with medication administration including medication administration records of 15 people who used the service and staff training records. We found that improvements had been made.

People told us that they were satisfied with the service that they were provided with and that their care workers treated them with kindness and respect. One person said, "I am very happy with them, I would not consider changing them ever." Another person said, "I am more than happy with (care worker), they are courteous and gentle with me." Another person told us, "They are great, do what I ask and do it well." Another said, "I have no complaints, they are very good."

We looked at the care records of ten people who used the service and found that people experienced care, treatment and support that met their needs and protected their rights. We found that medication adminstration records were not appropriately completed to show that people had been assisted with their medication at the prescribed times.

We looked at the personnel records of four care workers. We found that recruitment checks were made to ensure that people who used the service were suitable to work with vulnerable people. People were supported by care workers who were trained and supported to meet their needs.

There were systems in place to monitor and assess the service that people were provided with. Complaints were listened to and acted upon.

People we spoke with felt involved in planning their care package. The manager visited people in their home to carry out an assessment of their needs before care was provided.

We looked at five care plans. We saw that these were fully completed and contained personal details, care assessments, times of care visits, risk assessments, care plans and care worker visit reports. The care needs of the individual were clearly identified in the care plan.

The service had sufficient staff to meet the needs of the people who used it. People told us that staff were, "Usually on time" and "Encourage me to have a go myself". Staff had a structured induction programme and there was a system in place to ensure it was updated.