The Care Quality Commission
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Archived: Plan Care Welwyn Garden City

The Ridgeway, Little Ridge, Welwyn Garden City, Hertfordshire, AL7 2BH (01707) 396605

Provided and run by:
Taylor Gordon & Co. Limited

All Inspections

18 December 2014

During an inspection looking at part of the service

We carried out an announced comprehensive inspection of this service on the 10 April 2014. A breach of legal requirements was found. As a result we undertook a focused inspection on the 18 December 2014 to follow up on whether action had been taken to deal with the breaches.

You can read a summary of our findings from both inspections below.

Comprehensive inspection of 10 April 2014.

Plan Care Welwyn Garden City is a large domiciliary care and supported living agency. It is registered with the Care Quality Commission (CQC) to provide care and support for older people with a range of physical, social and psychological needs. On the day of inspection the agency was providing personal care to 335 people in the community.

The agency had a registered manager. A registered manager is a person who has registered with CQC to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

We spoke with three people in a supported living home who all spoke positively about the service. We telephoned 13 people who received personal care from the agency in their own homes. We received mixed feedback from these people. The three people we spoke with in a supported living home, said they were very happy with the staff, who understood their needs and helped them to remain as independent as possible. Nine out of 13 people we spoke with who received care within their own homes said they were unhappy with the level of communication they experienced with the office staff but were satisfied with the staff who provided their personal care.

When we talked with staff, four were unaware of legislation regarding the Mental Capacity Act 2005, even though training had been provided. This meant staff may not recognise when an assessment under the Act was necessary to protect people in their care.

There were not always enough staff available to provide the care and support needs for people in their own homes and we found that people were not always informed if their regular staff could not make the visit to provide their care or if they were going to be late.

Although there were some general risk assessments covering the environment and moving and handling, the welfare and safety of some people who used the agency were at risk because they did not have individualised risk assessments that detailed how the risks could be minimised to protect them and the staff.

Staff had completed training in safeguarding and whistleblowing. They also told us that they undertook the provider’s core training to develop their knowledge and skills so that they provided good care for people and could meet their individual care needs.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Focused inspection of 18 December 2014.

After our inspection of 10 April 2014 the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches in the report.

We undertook this announced focused inspection to check that they had followed their plan and to confirm that they were now meeting legal requirements. The provider was implementing a new risk assessment document which had been developed in response to the concerns raised. We looked at five care plans, however these had not been amended in response to the concerns raised at our previous visit and did not provide staff with adequate guidance on how to meet peoples care needs. In response to concerns the provider had made the appropriate changes to ensure that people's views were respected regarding the choice of gender of care staff providing their care. There had been improvements made in relation to communication from staff when they were running late, however, this did not happen all the time. The call logs still showed that people were regularly late. The provider had not allowed for travel time between calls which meant that staff continued to be regularly late.

10/04/2014

During a routine inspection

Plan Care Welwyn Garden City is a large domiciliary care and supported living agency. It is registered with the Care Quality Commission (CQC) to provide care and support for older people with a range of physical, social and psychological needs. On the day of inspection the agency was providing personal care to 335 people in the community.

The agency had a registered manager. A registered manager is a person who has registered with CQC to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

We spoke with three people in a supported living home who all spoke positively about the service. We telephoned 13 people who received personal care from the agency in their own homes. We received mixed feedback from these people. The three people we spoke with in a supported living home, said they were very happy with the staff, who understood their needs and helped them to remain as independent as possible. Nine out of 13 people we spoke with who received care within their own homes said they were unhappy with the level of communication they experienced with the office staff but were satisfied with the staff who provided their personal care.

When we talked with staff, four were unaware of legislation regarding the Mental Capacity Act 2005, even though training had been provided. This meant staff may not recognise when an assessment under the Act was necessary to protect people in their care.

There were not always enough staff available to provide the care and support needs for people in their own homes and we found that people were not always informed if their regular staff could not make the visit to provide their care or if they were going to be late.

Although there were some general risk assessments covering the environment and moving and handling, the welfare and safety of some people who used the agency were at risk because they did not have individualised risk assessments that detailed how the risks could be minimised to protect them and the staff.

Staff had completed training in safeguarding and whistleblowing. They also told us that they undertook the provider’s core training to develop their knowledge and skills so that they provided good care for people and could meet their individual care needs.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

10 April 2014

During an inspection

23 August 2013

During a routine inspection

People who use the service were given appropriate information and support regarding their care or treatment. We spoke with 14 people who used the service and we sent surveys out to 61 people. Most of the people we spoke with, and received surveys from, told us they were involved in planning their care and were given information they could understand in relation to their needs.

We saw that people's care needs were assessed and reviewed. We spoke with people who used the service who were positive about the care received. One person told us, "When they say carer, they mean carer, they can't do enough for you."

The service had a safeguarding people from abuse policy which all staff were familiar with. We spoke with nine staff members who were all able to tell us what abuse was and what they would do if they were concerned about a persons' welfare.

We looked at nine staff files and saw that they all included the appropriate recruitment checks. There were certificates that demonstrated that staff had the appropriate knowledge and skills for their role.

We saw that the service reviewed the quality of service provision regularly through analysis of late visits, care plan audits and telephone surveys with people who used the service.

22 February 2013

During an inspection looking at part of the service

When we inspected this service in November 2012 we found failings in the provider's ability to monitor the quality of service and to use information effectively to make improvements. There had not been enough skilled staff to meet people's needs leading to a high level of missed and late calls. Care workers were not receiving regular supervision. We required the provider to make improvements.

We inspected the agency again on 22 February 2013 and found the provider had introduced a new system to ensure that appropriate numbers of staff with the appropriate skills were recruited. People's experience of the timeliness of calls had improved as had the experience of the staff.

One person using the service said, 'I'm very pleased with them. They arrive on time and everything is going smoothly. I have the same carer most of the time except once when they were on leave.'

A staff member said, 'The rotas are better and we have time for travel. There are more staff in the office and they answer quickly.'

Staff were well supported and motivated to carry out their role because they experienced effective leadership. Staff were supervised and given relevant training.

We found that the provider had an effective system for monitoring the quality of service that included the auditing of call data. We also saw that people's feedback and complaints were acted upon.

13, 23 November 2012

During an inspection looking at part of the service

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Most of the people we spoke with told us that they were happy that the care workers had the information that they needed to care for them. One person said, 'My care workers are very good, they know what help I need to wash and dress.' The relative of another person who lived with dementia said, 'There has been a huge improvement in timekeeping and continuity.'

There were not enough qualified, skilled and experienced staff to meet people's needs. We spoke with several care workers who told us that they were frequently asked to take on additional calls due to shortage of staff, which meant that they could not complete all the visits to people at the right time.

One person told us that they had a lot of changes of care worker because many care workers had left. Another person, who required four calls a day to meet their needs, said, 'My evening care worker is very, very good. But other care workers come at all times, especially at weekends.'

There was no evidence that care workers received regular supervision and support to provide a good quality of care to the people they supported. All the care workers who we spoke with said that they had not had any supervision where they could discuss their work and development needs. Most of the staff files that we saw contained no records of individual supervision.

31 May and 7 June 2012

During an inspection in response to concerns

We spoke with 10 people who use the service. The feedback we received from most people was that they were happy with the care they received from staff at the service. People told us they felt they were involved in their care and care planning, and were given choices by the care workers with regards to their preferences. One person told us, "They came along at the start and asked everything and anything about what I want". Another person told us, "My carer is wonderful", and another said they received, "Excellent care." Three people however, told us they hadn't been involved in their care planning and that the staff at the service hadn't responded to their request to change their care to meet their needs.

Most people told us the care workers treated them with respect, with positive comments such as, "They're lovely, they really are." Most people told us that staff cared for them well, but a few felt that some of the staff did not appear to be aware of their needs or that they were particularly caring. People told us they were able to give feedback to the staff at the agency about their care and most had been involved in telephone surveys or questionnaires to give their views on the service they were receiving.