Archived: Waymarks Limited

Waymarks Limited provides personal care and social support to people living in their own homes in a 'supported living' setting. At the time of our inspection there were seven people receiving the regulated activity. Support workers staffed each house 24 hours a day. Following our visit to the service, the provider changed address and is now operating from a different location.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Staff recruitment was not safe. People were at risk of potential harm as staff did not have adequate pre-employment checks or risk assessments. Staff recruitment records were not always present. Governance arrangements were not effective to ensure there was robust oversight of the service.

The provider and registered manager had not investigated or reported to the local authority some safeguarding concerns staff had raised. Where incidents had been recorded, management monitored these to check action was taken.

Medicines were administered safely. However, management had not ensured staff member’s competency to give people medicines had been checked every six months as the provider expected. Staff kept accurate records of the medicines they had given.

Staff did not have regular opportunities to have one to one supervision. Staff had completed the training they needed. Staff supported people to have enough to eat and drink and to access health care services. 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.

People's needs were assessed when they started receiving the service. This was used to develop a brief support plan called ‘a support plan light’. The provider was transferring care plans into a more detailed format, so they contained more information about the support people needed. One complaint had been fully investigated and resolved.

The new service manager was making improvements and providing more effective oversight of the service. A detailed quality assurance audit had been completed and an action plan developed. People, relatives and staff had opportunities to give feedback about the service.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 October 2017).

Why we inspected

We undertook this initially as a targeted inspection to check on a specific concern. This was prompted in part by a statutory notification that was sent to CQC of an alleged incident. This incident is subject to a criminal investigation. This inspection did not examine the circumstances of the incident.

CQC are currently trialling targeted inspections, to measure their effectiveness in following up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We widened the inspection to a comprehensive inspection after the first visit to assess whether there were any additional risks to people using the service.

We have found evidence the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Enforcement

We have identified breaches in relation to the suitability of staff, record keeping, good governance and safeguarding. Please see the action we have told the provider to take at the end of this report.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Waymarks Limited provides personal care and support to people with a learning disability who are living in their own homes. On the day of our inspection there were six people receiving personal care from the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and described potential risks and the safeguards in place to mitigate these risks. The manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate procedures were in place to ensure people received medicines as prescribed.

There were sufficient numbers of staff on duty in order to meet the needs of the people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Waymarks Limited. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person-centred way.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The provider had an appropriate complaints procedure in place, and people who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the management team and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys. Family members told us the management were approachable and communication was good.