CWD Outreach Service

Updated 7 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection activity started on 17 November 2017 and ended on 03 January 2018. We visited the office location on 17 November 2017 to see the manager and office staff; and to review care records and policies and procedures. We conducted phone calls to relatives and staff after the office visit.

The inspection was carried out by one inspector, a nurse specialist in paediatric care and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we gathered information about the service by contacting the local and placing authorities. In addition, we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

As part of our inspection we spoke with five relatives. We spoke with the registered manager and four care staff. We read care plans for eight children, medicines records and the records of accidents and incidents, complaints and safeguarding. We looked at records of audits, surveys and the provider’s development plan.

We looked at three staff recruitment files and records of staff training and supervision. We reviewed a selection of policies and procedures and health and safety audits. We also looked at minutes of staff meetings, records of spot checks and evidence of partnership working.

Updated 7 February 2018

The inspection took place on 17 November 2017 and was announced. Our last inspection was in July 2016 where we identified two breaches of regulations relating to risk assessments and governance. At this inspection, the provider had made improvements to meet the requirements of the regulations.

Surrey Children’s Domiciliary Care Service provides support to children with a range of disabilities who have been assessed by a social care team as requiring a personal care service within the family home. Staff supported children with physical disabilities, learning disabilities, autism and managing their behaviours.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to children who live at home with their families. At the time of our inspection, the service was supporting 35 children.

There was a registered manager in post. 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.

Risks to children were routinely assessed with clear plans in place to keep them safe. There had been very few accidents or incidents, but staff responded appropriately where they occurred. Staff understood their roles in safeguarding children and we saw evidence of staff responding to concerns correctly. The service regularly played a role in multi-agency plans to keep children safe. Consent was sought from parents or children where they were old enough. Staff understood when the Mental Capacity Act (2005) could apply to the care that they delivered.

Staff worked alongside healthcare professionals and relevant agencies involved in children’s care. Where staff administered medicines, they had been trained to do so and clear records were kept in this area. Children, families and staff had access to support in the event of a child receiving end of life care. Relatives told us that staff were on time and they observed staff following good infection control practice on visits.

Children’s care was delivered in a way that met their needs, preferences and family routines. Staff supported children to attend schools and activities as well as to go on outings and to play. Children’s care was regularly reviewed and any changes were actioned by staff. Children and their families were regularly consulted in the quality of the care that they received. The provider had a clear complaints policy and relatives knew what to do if they wished to raise concerns.

Staff had the training that they needed to support them in their roles. Staff spoke highly of the management at the service and said that they felt supported and had opportunities to make suggestions. The provider had systems in place to enable effective communication between staff and ensured staff had access to secure, up to date records.

Staff routinely ensured children and their families were involved in their care. Choices were offered in line with routines and preferences and relatives told us that staff were respectful when entering their homes. The management had a clear vision for the service and an ongoing plan was in place to improve the service and deliver high quality care.