Westminster Homecare Limited – Luton

Westminster Homecare Ltd (Luton) is a domiciliary care agency providing personal care to people in their own home. At the time of the inspection the service was supporting 144 people.

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 said they felt safe. Some found changes to regular staff teams unsettling but understood the registered manager was trying to cover absences due to the impact of the COVID-19 pandemic.

People had detailed risk assessments in place and staff told us that staff understood their needs and how to support them in ways they preferred. Staff had a good knowledge of the risks related to people’s health conditions and had received training and support to develop their skills in this area.

People’s care plans were person-centred and included information about the person’s history, health needs, preferences and social relationships. Staff felt there was enough information in people’s care plans to be able to provide safe and personalised care.

The staff team were not currently supporting anyone receiving end of life care, however, there were relevant policies in place and a number of staff trained in this specialism should it be required.

Staff were able to demonstrate a good understanding of the extra care, support and considerations required to support people and their relatives in a dignified and pain-free way at the end of their life.

We made a recommendation about improving how communication needs are supported and recorded.

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 10 October 2019). 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 and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about the quality of care and safeguarding processes. We also planned to review the outcomes of the concerns identified at the previous inspection in relation to risk management and person-centred care. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and responsive sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Westminster Homecare Limited is a domiciliary care agency providing personal care to 197 people at the time of the inspection.

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 told us they felt safe but records did not always promote safe practice because risks were not always fully assessed and documented. People were receiving their medicines correctly and on time and medicines were being safely managed and administered.

People’s care needs were being met but the care records did not promote personalised care. People were involved in making decisions about their care and treatment. People knew how to make complaints and these were fully investigated and improvements made. We have made a recommendation about documenting person centred approaches to care.

People were supported to access health and social care professionals when they required this and staff were well trained to meet people’s needs. People’s wishes for the end of their life were not sought or recorded.

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.

People were consulted regularly to input into how the service delivers care and information was shared with them regularly. There were a lot of forums people could choose to become involved in to socialise and to engage with the staff team.

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

Rating at last inspection: The last rating for this service was good (published 24 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement:

We have identified a breach in relation to risk assessments to keep people safe at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This announced inspection was carried out between 13 January 2017 and 21 February 2017. The service provides care and support to people in their own homes in the community and to those living within two local extra care housing schemes. At the time of the inspection, 129 people were being supported by the service, some of whom may be living with chronic health conditions, physical disabilities and dementia.

The service did not have a registered manager. 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 recently been employed, but they left the service within two weeks of being in post. The operations manager was regularly based at the service and provided stability during periods when there had been no manager.

People were safe because the provider had effective systems to keep them safe, and staff had been trained on how to safeguard people. There were individual risk assessments that gave guidance to staff on how risks to people could be minimised. People’s medicines were managed safely and administered in a timely manner by trained staff. The provider had effective recruitment processes in place and there was sufficient numbers of staff to support people safely.

Staff received effective training, support and supervision that enabled them to provide appropriate care to people who used the service. Staff now understood their roles and responsibilities in ensuring that people consented to their care and support, and that this was provided in accordance with the requirements of the Mental Capacity Act 2005 (MCA). Where required, people were supported to have enough to eat and drink.

Staff were kind and caring towards people they supported. They treated people with respect and supported them to maintain their independence as much as possible. People were happy with how their care was provided and they valued staff’s support. People had developed friendly relationships with staff who supported them regularly.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences and choices. Care plans had been reviewed annually or when people’s needs changed. Staff were responsive to people’s needs and where required, they sought appropriate support from healthcare professionals. The provider had a system to manage people’s complaints and concerns.

The provider had systems to assess and monitor the quality of the service. They encouraged feedback from people, relatives and staff to enable them to continually improve the service. However, most people and staff we spoke with were confident that the service was well managed. They attributed this to the changes in managers in the last couple of years. People and staff did not always find office staff approachable and helpful. The provider made improving this their priority.

We found that people's needs had been assessed to ensure the care they received was safe and effective.

The agency had procedures in place to ensure that people were safeguarded against the risk of abuse and staff had been provided with appropriate training.

We found that the agency had an infection control policy to promote good infection control practice. Staff showed a good understanding of infection control processes. For example, a staff member said, 'We always wear gloves and aprons when providing personal care.'

We found that the agency had effective recruitment procedures to ensure appropriate checks were undertaken before staff commenced work. Staff were appropriately supported to enable them to deliver safe and effective care to people who use the service.

We found that the agency had a system in place to assess and monitor the care provided to people. This ensured people were listened to, acted on and concerns addressed in a timely manner.