Archived: West Midlands

West Midlands is a domiciliary care service and supported living service providing personal care to people living with a physical disability and a learning disability. At the time of our inspection, there was 1 person receiving support as part of a supported living service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Actions had not always been taken to address the concerns raised at the last inspection. Protocols to guide staff when to administer ‘when required’ medicines were not in place. Recruitment documentation had been reviewed but action had not yet been taken to address gaps in recruitment files. For example, induction records were not always complete or checked by the registered manager to ensure staff had the training they needed to gain the skills and knowledge to be competent. Systems in place to check the quality of the service had not yet been embedded so the provider could not be assured whether they were effective in checking the quality of the service. The provider had developed audit tools to check the quality of the service, but they were not yet being used. Staff supervisions had been arranged but staff had not yet received supervision to check they had the skills to meet people’s needs effectively.

Staff supported the person to have choice and control over their life. Staff supported the person to be independent. The person was supported by staff to pursue their interests and engage in activities of their choice. Staff supported the person to play an active role in maintaining their own health and wellbeing.

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:

The person was supported by staff who treated them with kindness and compassion. Staff respected the person’s privacy and dignity. Staff understood how to keep the person safe and protect them from abuse. The person was supported by staff who were appropriately skilled to meet the person’s needs and keep them safe. The person was supported to take positive risks and risk assessments were in place to manage this risk.

Right Culture:

The person told us they thought the world of the staff. The person felt valued by staff who supported them. The person was supported by staff who were keen to learn and improve their knowledge around the person’s needs. Staff understood the person well and knew how to meet their needs. The person was involved in the planning of their care. The registered manager promoted a culture at the service that improved the person’s quality of life.

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 17 February 2023).

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 but the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Enforcement

We have identified breaches in relation to the governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

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

West Midlands is a domiciliary care service and supported living service providing personal care to people living with a physical disability. At the time of our inspection, there was 1 person receiving support as part of a supported living service.

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 did not have protocols in place to ensure the safe administration of ‘as required’ medicines. Accidents and incidents were not always recorded accurately. The provider did not always ensure recruitment checks were undertaken which ensured people were supported by suitable staff.

Staff did not have training delivered by a suitable training provider. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People’s needs were not always assessed holistically and did not always consider people’s diverse needs under the Equality Act 2010.

Relatives told us staff were kind and caring. However, we found staff had used derogatory language in people’s care records. Staff promoted people’s independence but did not always enable them to make choices for themselves where there was a perceived risk.

Care plan documentation was not always up to date and consistent. Systems were not always in place to adequately check the quality of the service and identify improvements required. The registered manager did not always have the knowledge to ensure concerns were identified, and improvements made when needed.

A relatives told us their family member was safe. Staff knew the types of abuse and understood how to keep people safe. Staff wore personal protective equipment (PPE) in line with current guidance. The person was supported to eat and drink in line with dietary preferences and choices. The person was supported to have their health needs met and were supported to attend health appointments. The person was supported by staff who communicated with them in a way they understood. Staff told us the registered manager was approachable and supportive. The registered manager promoted a positive culture amongst staff.

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

Rating at last inspection

This service was registered with us on 15 May 2019 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to consent, staff training and the governance of the service at this inspection.

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