Archived: Westminster Homecare Limited (Oxford)

There wasn’t a registered manager in post at the service. 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. A new manager had been appointed and started in October 2015. The manager was in the process of submitting their application to become a registered manager with the Care Quality Commission to manage the service.

At our last inspection on 29 January 2015 we found people did not always receive information which was important to them and affected their day. We also found staff did not always receive supervision, appraisals and not always had the training they needed to meet people’s needs. The provider had implemented quality assurance systems which were not always effective. Following our inspection we asked the provider to send us an action plan telling us how they would meet the regulations.

At this inspection we found some improvements had been made and the provider was in a process of implementing further changes to meet the required standard. However we found another area where improvements were required.

People using the service were safe because staff understood their responsibilities for safeguarding people from abuse and avoidable harm. Safeguarding procedures were in place to ensure people were safe from abuse and staff were aware of the whistleblowing policy.

People’s files contained risks assessments related to mobility, medication, moving and handling, using a wheelchair, hoisting a person and other. However, we found the risk assessments were of a generic nature and lacked person specific details and management plans to minimise the risk.

People who used the service were mostly positive about the knowledge and skills of staff who supported them. Staff said the training they received was good and gave them confidence in their roles. People were complimentary of staff and gave positive comments. There was consistency in staffing as staff had supported the same people over a period time. This helped staff to know people’s needs and preferences, and develop good working relationships with them.

Staff spoke positively about the support they received from the management. Staff supervision records were up to date and the manager was in a process of carrying out annual appraisals.

Recruitment checks had been carried out to ensure only staff who were suitable and of a good nature were employed to work with people. People were supported to maintain good health and received support, where needed, with their nutritional needs. People told us that the staff were professional, gentle and kind and treated them with dignity and respect.

The provider had an appropriate complaints procedure and people told us they knew how to complain. The provider used an annual survey to obtain people’s feedback about the service.

We received positive feedback about the new manager. The manager was aware of further improvements required to the service. They were in a process of reviewing their arrangements for monitoring the quality of the service. These arrangements were in their early stages but they were recognising signs of improvement. The manager undertook a number of quality assurance audits to monitor the standard of the service and planned to implement further audits and an ongoing service improvement plan.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) 2014. You can see what action we told the provider to take at the back of the full version of this report.

We found people received the care they needed in the way they preferred. All ten people and two relatives we spoke with were complementary about the agency and made positive comments about the care delivered by the care workers. A relative told us, 'We really landed on our feet with Westminster Homecare. They are excellent, I cannot speak more highly of the service'. We found that care workers were on time and calls were not missed.

Care workers treated people with dignity and respect. For example we observed care workers addressed people in the manner they preferred and using titles where this had been requested. They also ensured that people's privacy was protected when care tasks were undertaken. People told us that the agency was flexible which enabled them to plan their care around their lives.

We found that care workers were familiar with the risks described in people's care plans and knew how to support people appropriately. One relative told us, 'They will never take the risk of moving my husband without the use of the hoist'.

The agency had suitable arrangements in place to protect people from the risk of abuse. Care workers we spoke with knew how to identify abuse and how to implement the safeguarding procedure. We found that any identified or suspected abuse was addressed appropriately.

Care workers received training and systems were in place to support staff and monitor their competency to undertake care tasks. This meant that people could be assured that they were cared for by appropriately trained staff.

We found that systems were in place to enable the manager to monitor the quality of the service provided and to identify and respond to risks. We saw that complaints had been investigated and concerns addressed appropriately.