Archived: North West Community Services Ltd

Updated 30 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 09 February 2016 and was unannounced. The inspection was carried out by two adult social care inspectors from the Care Quality Commission.

We reviewed information we held about the service in the form of notifications, safeguarding incidents, injuries and whistleblowing information we had received. We also liaised with relevant professionals in advance of the inspection in order to ascertain their views of the service. This included to local quality assurance team based within Wigan Council.

As part of the inspection spoke with the registered manager, two service managers, six people who used the service, nine support workers and a team leader. Two other people who used the service had originally agreed to speak with us, however later declined. We looked at records held by the service, including medication records, care plans, staff files, audits, training records and meeting minutes. We also visited seven of the houses where people lived to check the environments, look at relevant paperwork and speak with staff.

Updated 30 March 2016

We carried out this unannounced inspection on 09 February 2016.

Our last inspection of this service was in June 2013, where all standards were met. The provider had since moved premises and this was the first time we had inspected at their new location. North West Community Services supports adults who have a learning disability through supported living and domiciliary care provision. The head office is located in the Standish area of Wigan, Greater Manchester.

At the time of the inspection the service supported approximately 43 people, across 15 different houses, some of which were vacant. The houses where people lived are owned by different landlords and housing associations and any maintenance work, or improvements to the living environments, are completed by them on request.

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 told us they felt safe as a result of the support they received. Staff demonstrated a good understanding of safeguarding procedures and how they would report concerns about people’s safety.

In advance of our inspection we received information of concern about the service, informing us that several of the houses were not maintaining high standards of cleanliness. As part of the inspection we checked some of the houses where concerns had been identified and generally, found them to be clean and tidy, with appropriate cleaning tasks being undertaken by staff and checklists maintained. In one of the houses, we identified mould around a bath, with damp on the ceiling, whilst in another the kitchen floor was dirty with stains on the wall. Staff said they tried to clean it but to no avail. We raised this with the manager who contacted the landlord of the properties to arrange for these to be replaced immediately.

We found medication was handled safely, although one person had a missed dosage of medication on one day because the medication had run out. This had been re-ordered by a team leader, however they were unsure when it would arrive. As a result, the manager arranged further training for the staff involved.

People were protected against the risks of abuse because the service had a robust recruitment procedure in place. Appropriate checks were carried out before staff began work at the service to ensure they were fit to work with vulnerable people.

Staff told us they felt staffing levels were adequate and that absences were covered when required. Some people required 2:1 support and we saw these staff were present in some of the houses we visited.

Staff told us they felt supported to undertake their work and had access to enough training. Staff also said they undertook an induction when they first started working for the company. However, in one of the houses we visited, a member of staff told us they had been punched by a person who lived there. This member of staff said they had worked for the service since October 2015 and had not yet completed training in breakaway techniques. We raised this with the manager who said this training would be arranged immediately.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Staff told us they had undertaken recent training and were able to provide examples of when people may be deprived of their liberty.

People told us they had enough to eat and drink and had choices of different food and drink. We found people had appropriate nutrition care plans and risk assessments in place where required.

People told us they were treated with dignity and respect staff, who offered them choices and encouraged them to be as independent as possible. There were also ‘Dignity champions’ who worked for the service, where this area was explored in greater detail.

Each person who used the service had a support plan in place, which provided staff with an overview of their support needs and what they needed to do. These were located at people’s houses so staff could update them as required.

There was a complaints procedure in place. The service user guide also referred specifically to complaints and explained the process people could follow if they were unhappy with any aspects of the service.

The staff we spoke with were positive about the management and leadership of the service. Staff felt the manager was approachable and supported them to carry out their work to a high standard.

We found there were appropriate systems in place to monitor the quality of service effectively. This included regular audits of each house where people were supported, seeking feedback from people through the surveys and the close monitoring of accidents and incidents. This meant the service could continually improve as a result.