Archived: Wandsworth

If you want to see the evidence supporting our summary please read the full report.

We considered our inspection findings to answer five questions we always ask;

' Is the service safe?

' Is the service caring?

' Is the service responsive?

' Is the service effective?

' Is the service well led?

Is the service safe?

The agency's safeguarding procedures are robust and managers and staff understood how to protect the vulnerable people they supported.

We saw staff regularly assessed potential risks to people's health and welfare within their own home. There was appropriate guidance for staff on how to manage identified risks and keep people safe.

Staff recruitment practice was safe and thorough. We saw staff had been subject to disciplinary action as and when it was appropriate.

Staff duty rotas indicated that the care coordinators always took account of people's care needs when making decisions about the numbers, skills and experience of the care staff required to cover home visits. This helps to ensure that people's needs are always met.

We found there were robust systems in place to ensure that management and staff learnt from events that adversely affected the people using the service, such as incidents, complaints and safeguarding investigations. This minimises the risk of harm to people using the service and ensures that lessons are learnt from near misses and mistakes.

Is the service caring?

People we spoke with told us they were happy with the care and support provided by the agency and that staff were kind and caring. Typical comments we received included, 'I am very satisfied with the support I get from the girls that visit me', 'The carers are all marvellous' and 'I know my mother is happy with her carers'.

We observed the way care workers interacted with a person who received domiciliary care services from the agency and saw they treated the individual with the utmost courtesy, respect and dignity.

People's needs were risk assessed by suitably trained staff before they were allowed to receive any domiciliary care services from the agency. People's care and support needs had been recorded in their care plan and support was provided in accordance with their wishes.

People were supported by kind and attentive staff. We saw that care workers showed patience when supporting people who used the service.

It was evident from comments we received from staff and care practices we observed that where possible the agency tried to match people using the service and care workers who shared similar ethnic backgrounds and/or culture.

The views of the people using the service and their relatives were routinely sought by the provider who regularly telephoned individuals and used bi-annual client satisfaction surveys to find out what people thought about the quality of the care and support the agency provided.

Is the service responsive?

During our last inspection of this provider we found that the needs of the people using the service might not always be met because some care workers did not always turn up when they were meant to or stay for their agreed length of time. The provider responded well to the concerns we identified by introducing an electronic call monitoring system which enabled managers and senior staff to check whether or not care workers arrived at a person's home and stayed the agreed time. People we spoke with told us their care workers usually turned up when they were meant to, or let them know if they were running late, and always stayed for the agreed length of time. One person said 'They (care workers) are very rarely late and they will always let you know if they going to be'. Another person told us 'Sometimes the carers are late because of the buses, but they always ring to let you know.'

We found staff continually monitored people's condition and where necessary sought the advice and assistance of other community based health and social care professionals, such as GPs, district nurses, hospice staff and care managers.

The views of people using the service and their relatives were taken into account by the agency and we found evidence that indicated the provider had made changes to improve the overall quality of the care and support based on this feedback.

People knew how to make a complaint if they were dissatisfied or unhappy with the service they received. One person said that they had made a formal complaint and were satisfied with the way the agency had dealt with their concerns. We looked at how the agency dealt with all the complaints it had received in the past six months and saw that the acting manager's responses had been open, thorough and timely. People can therefore be assured that complaints will be investigated and where possible appropriate action taken to resolve the issue to the complainants satisfaction.

Is the service effective?

We saw that people's care and support needs were assessed with them and their relatives and that they were involved in helping staff develop care plans, which reflected their current needs and wishes. It was also clear from speaking with staff that they understood people's care and support needs, and were familiar with their wishes and preferences.

We found staff had received training to meet the needs of all the people using the service and were well supported by the agency's management and senior staff team. Staff we spoke with were clear about their care worker and care coordinator roles and responsibilities.

Is the service well-led?

In this report the name of the registered manager/owner appears who was no longer in day-to-day charge of the agency at the time of our inspection. The service is now being run by the acting manager who has submitted an application to become the branches new registered manager. The acting manager has been in day-to-day charge of the agency for the past twelve months, is very experienced and was able to demonstrate that they had the knowledge and skills to manage the service well.

People using the service and relatives we spoke with said the leadership of the service was excellent and staff we met felt the Wandsworth branch of Aquaflo was a good place to work.

The service worked in partnership with other key agencies, including local GP practices, hospices, Clinical Commissioning Groups (CCG) and local authority safeguarding vulnerable adult's teams, to ensure people received their care and support in a joined up way.

The provider carried out regular checks to assess and monitor the quality of the service the agency provided. We also found the service had systems in place that ensured that staff had the opportunity to provide regular feedback to their line managers, so their knowledge and experience was taken into account.

However, although most people said they were satisfied with the service provided by Aquaflo; seven stakeholders told us they felt the needs of the people who used the service were not always met. This was because carers sometimes turned up late and/or did not stay for the agreed length of time. This meant some support tasks the agency agreed to do were not always completed. One person told us 'the staff are lovely and very caring, but some of their time keeping is very poor indeed'. A second person said 'the staff usually get the job done, but I wish they would stay the full hour as we had agreed with the agency. Sometimes carers leave after 15 or 30 minutes'. Another individual told us 'I can't fault the attitude of most of the carers that visit us, but sometimes only one turns up, which means they are not able to transfer my mother properly'.

Overall, we found evidence that indicated people received safe care and support from suitably trained and supported staff.