Archived: Weymouth - Care at Home

Weymouth Care at Home is registered to provide personal care to people living in their own homes. At the time of the inspection the service provided personal care and support to 126 people living their own homes in the Weymouth 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.

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

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. The policies and systems in the service supported this practice. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Staff demonstrated a good awareness of safeguarding procedures and knew who to inform if they witnessed or had an allegation of abuse reported to them.

People and their relatives were very positive about the service and the care provided. A relative said, “This is a great care company and we are very happy with the care and support we get. Sometimes the carers are quick to pick up on any marks so help to prevent bed sores.”

Sufficient staff were available to meet people's needs, and people told us they were supported by staff they knew. Some people were disappointed that they did not receive a rota informing them who would be coming and at what time. The service was addressing these concerns.

The service continued to be effective. People's needs were assessed, and care was planned and delivered to meet legislation and good practice guidance. Care was delivered by staff who were well trained and knowledgeable about people's care and support needs. Staff told us they were happy working for the service and there were opportunities for development.

Staff were responsive to people's individual needs and wishes and had an in-depth knowledge about each person. People were supported to access healthcare services if needed.

The service advised people of the action to take if they wished to make a complaint or were not happy with the providers response. People told us they knew how to complain if they needed to, and were confident if they had any concerns these would be addressed by the service.

People received support to take their medicines safely. Risks to people's well-being and their home environment were recorded and updated when their circumstances changed. Where errors occurred, the service learnt lessons.

The service continued to be well led and benefitted from clear and consistent leadership. The registered manager had a clear vision about the quality of care they wanted to provide. Staff were aware of their roles and responsibilities. Systems were in place to monitor the quality of care provided and continuously improve the service. The management team and staff engaged well with other services and had developed positive relationships.

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

Rating at last inspection and update:

The last rating for this service was Good (published 06 January 2017). At this inspection the service remained Good.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Weymouth Care at Home is registered to provide personal care to people living in their own homes. At the time of our inspection the service provided personal care and support for 137 people.

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.

People were positive about the care and support they received. They told us staff treated them kindly and we saw people were comfortable with staff in their homes. Staff were consistent in their knowledge of people’s care needs and spoke with confidence about the care they provided to meet those needs. They were motivated to provide the best care they could and told us they felt supported in their roles. They had received training that provided them with the necessary knowledge and skills to do their job effectively. Staff kept accurate records about the care they provided and these records were used to review people’s care.

There were enough safely recruited staff to ensure people received their visits as planned. People told us they mostly received visits on time and were contacted if the care worker was running late due to traffic or an emergency.

Staff understood how people made choices about the care they received, and encouraged people to make decisions about their care. Care plans reflected care was being delivered within the framework of the Mental Capacity Act 2005.

People felt safe. They were protected from harm because staff understood the risks they faced and how to reduce these risks. Staff knew how to identify and respond to abuse; including how to contact agencies they should report concerns about people’s care to.

People’s medicines and creams were administered safely although one person was not receiving their medicines at the correct time. This was rectified immediately.

People had access to health care professionals and were supported to maintain their health by staff. Staff understood changes in people’s health and shared the information necessary for people to receive safe care. Where people had their food and drink prepared by staff they told us this was prepared well. People were left with access to appropriate drinks and food between visits.

Management were committed to making continual improvements to the quality of care. This included development of new skills and expertise amongst the staff team such as the introduction of training in end of life care. There were systems in place to review and monitor the quality of the service people received including feedback from people and staff.

People were positive about the care they received and told us the staff were friendly and compassionate. Staff treated people and each other with respect and kindness throughout our inspection.

Is the service safe?

Care was planned and delivered in a way that was intended to ensure people's safety and welfare. Risk assessments were regularly reviewed and amended according to changes identified. Effective assessment of care needs and management of risks showed how the service supported people's welfare and took appropriate steps to ensure their safety.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Where potential abuse was identified appropriate steps were taken to notify key authorities, and to safeguard people from further harm.

The provider's systems and training ensured staff worked in line with the Mental Capacity Act 2005 (MCA) and people were protected against the risk of unlawful or excessive control.

The provider had appropriate arrangements in place to ensure people were protected against the risks associated with medicines.

Is the service effective?

People's needs were effectively identified and assessed, including in areas such as nutrition, mobility and personal care. Care plans to meet those identified needs were then clear and concise.

People's needs continued to be met if and when they changed, because care plans were regularly reviewed and were updated as necessary following changes to people's care needs.

Staff received regular and ongoing training related to meeting the needs of people at the service. This included administration of medicines, MCA, moving and handling and infection control. People using the service benefited from the provider taking steps to ensure staff were sufficiently qualified and skilled to provide effective care and support.

Is the service caring?

We spoke with 15 people who used the service and four of their representatives. They were all positive about the care and support provided by care staff. For example, one person who had used the service for a number of years told us, 'All of them do 100%, many of them do 120%. They've become friends, not just carers.'

Is the service responsive?

The registered manager responded positively and swiftly to address in full any minor concerns we raised during this inspection.

People who used the service and their representatives told us they felt they could raise any shortfalls or concerns with management and they would be addressed.

Staff communicated with a range of different health professionals on an ongoing basis, which showed how they responded to ensure people's changing health needs were met effectively.

Is the service well-led?

At our previous inspection we identified concerns across a number of different care standards and in regard to the level and quality of service provided. We found the provider had responded positively to the previous inspection's findings and had taken steps necessary to address the concerns we had raised.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This reduced the risks to people and helped the service to continually improve.

If a staff member's conduct fell below what was expected of them, we saw the registered manager took clear and proportionate action to address any performance concerns.

The provider and registered manager had appropriate experience of care provision and were knowledgeable about the systems and processes required for a domiciliary care agency's successful operation. Effective leadership meant staff followed those systems and processes, which helped to ensure people's care and support needs were met.

People who used the service were not protected from the risk of abuse, because staff did not understand their responsibilities regarding safeguarding. A member of staff told us that they had not reported an allegation of abuse to the safeguarding authority because of the person's mental health condition.

People were not always protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to ensure that all medicines were administered safely. One member of staff told us, 'There is a risk of them not taking their medication. They have dementia, they can't remember.'

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One member of staff told us, 'All training is up to date, useful and helpful. Any questions are answered.'

The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

Care documentation gave staff clear guidance regarding the delivery of care, and each individual's care plans reflected individual's personal preferences and wishes.

People told us that staff were friendly and polite in their approach. One person said, 'I couldn't fault anything about this service.' The staff that we spoke with were very knowledgeable about the people they cared for and felt well supported to undertake the role they were employed for. Without exception staff told us that they were happy in their job and believed they offered a good service. Many of the staff worried if they were delayed at a visit and late for the next call. People using the service were advised that a call could be 15 minutes different to that scheduled and if it were longer the provider would make contact with the person to advise them.

Records were well written and kept under review, and risk assessments were in place to minimise the risks and protect people in their homes.