At the last inspection on 7 January 2016, the service was in breach of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12 Safe Care and Treatment, Regulation 19 Fit and Proper Persons employed, Regulation 11 Consent, Regulation 18 (2) Staffing, and Regulation 17 Good Governance. The service was rated inadequate and placed in special measures.This inspection took place on 3 June 2016 and was announced.
WrightChoiceCare provides care and support to people living in their own home. The registered provider supports people with a range and variety of complex needs. They provide support to children and younger people with physical disabilities and / or learning disabilities and autism. They also offer support to older people some of whom live with dementia. The service is a family run business; the registered provider manages the service. They employ an assessment officer and a staff coordinator who form part of the management team. The management team also deliver care and support. The service operates in Wistow and the surrounding villages.
During this inspection we found the provider was no longer in breach of the previously identified regulations and had made improvements to the service and the care people received.
The service does not have a registered manager. This is because the service is run by a sole provider who is in day to day control of the service and therefore, it is not a legal requirement to appoint a separate registered manager.
Risks to people were identified and risk management plans were put in place to mitigate the risks and reduce the risk of avoidable harm. People, relatives and relevant professionals were, where required, involved in the development of these.
Medicines were now safely managed, staff had received up to date medicines training and underwent various competency checks before they administered people’s medicines.
Recruitment processes were safe. Reference checks had been sought and provided for all members of staff.
Staff training had been provided and the registered provider had carried out competency checks to ensure staff had the skills and knowledge required to deliver safe and effective care.
The service was following the principles of the Mental Capacity Act (2005) and we were given examples of how staff sought consent on a routine basis. Training and support had been provided to staff. Staff now understood the legislation and how this applied to people who used the service.
Arrangements for quality assurance and leadership within the service had improved.
People told us the service was flexible and responsive. People told us the fact that it was a family run business made a difference to them and they felt valued by staff and the management of the service.
The service is located within a small community and we saw some individual touches such as visiting people in hospital, supporting people to interact with their local community and looking after people’s animals which are positive aspects of local care.
Care was provided by a consistent team of care staff who people knew and trusted. People received a copy of their staff rota and so knew who would be visiting them in advance.
People told us they were supported to enjoy nutritious meals. The service referred people to health care professionals as required and worked with them to ensure people’s needs were met.
Staff described a supportive culture and they said staff morale was good.
People and their relatives, where appropriate, were involved in the development and review of their care plan. People told us they could speak with the registered provider or member of staff if they wanted any aspect of their care to change and this was accommodated. People knew how to make a complaint; however, they told us they had not needed to.
The registered provider had ensured the management team had time away from delivering hands on care to ensure the service was well-led. They had developed quality assurance systems to audit the care provided to people. Record keeping was robust.
Whilst we have seen significant progress we need to see consistent good practice over time, therefore we will continue to monitor the service and return to monitor the improvement and review these areas again at the next inspection.