Background to this inspection
Updated
3 October 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced.
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 16 September and ended on 17 September 2020. We visited the office location on 16 September 2020.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We also spoke to the registered manager about the progress they had made with their action plan since our last inspection. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and five relatives about their experience of the care provided. We spoke with twelve members of staff including the two representatives of the provider, registered manager, care coordinator, two office staff and six care staff. We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
3 October 2020
About the service
Westminster Homecare Limited (Cheltenham) is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 52 people were supported with their personal care needs.
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
Significant improvements had been made to the service and we found the service had met the breaches of regulation from the last inspection. On this inspection, we found that people’s care was personalised, and their care records provided staff with accurate information about their support requirements and risk management plans. Improved communication and on call arrangements ensured relevant information was appropriately shared between staff. People were supported to retain their independence and be involved in decisions about their care. End of life care processes were available to support people during their final stages of life.
Staff knew how to protect people from avoidable harm and abuse and where to report any concerns regarding people's safety and welfare. Accidents and incidents were reported and monitored for any trends. Safe systems were used to manage people’s medicines. New detailed protocols for ‘as required’ medicines had been implemented. Some people required support with their nutrition and hydration.
Extra control measures had been implemented to help prevent the spread of infection and the coronavirus. People confirmed that staff maintained good infection control practices, wore appropriate PPE and hand sanitation.
People and their relatives all complimented the staff and told us their approach was consistently caring and compassionate. There have been no missed calls since our last inspection and people who used the service stated staff were punctual or they were informed if staff were running late.
Improvements had been made to the training, support and deployment of staff. Staff knew people well and monitor their health. They referred people to healthcare services when their needs changed.
People and relatives told us their decisions and views were always respected. Staff practice complied with the principles of the Mental Capacity Act. 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 services supported this practice. Further training was going to be implemented to upskill senior staff to complete comprehensive MCA assessments around specific decisions.
A new registered manager had been recruited since our last inspection. Staff praised the registered manager for their support and dedication in making improvements across the service. The provider carried out regular quality assurance checks and visits to the branch to ensure the service met their regulatory requirements. The registered manager had a good oversight of the service and completed regular checks and audits to monitor the quality of care being delivered and to receive feedback from people and staff.
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 requires improvement (published 1 January 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.
This report only covers our findings in relation to the Key Questions Is the service Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westminster Homecare Limited (Cheltenham) on our website at www.cqc.org.uk.
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.