Archived: Care Connect Wirral Limited

The last inspection of this service was in March 2018. At that inspection the service was rated as requires improvement overall with well-led rated as inadequate. The service had been found to be in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as the registered provider had not applied good governance to the service. As a result, the service was rated as “inadequate” in the well led question we ask.

In response to this we issued the service with a warning notice. A warning notice is designed to highlight to the service that improvements were required within a set timescale or more formal enforcement action would be taken. This visit found that the warning notice had now been complied with.

This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to predominantly older adults. The service at present provides support to people predominantly in the Ellesmere Port and Wirral area. Not everyone using Care Connect Wirral receives personal care; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

During this visit, the registered provider supported 111 people with their personal care. There was 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.

At this inspection we identified that the required improvements had been made. While no breaches were identified at this visit, we have rated the location as requiring improvement overall. This is because the registered provider needs to demonstrate a period of sustained good practice to achieve a rating of good.

Improvements had been made in the auditing processes within the service. Key documents such as care plans, risk assessments, recruitment records, notifications to CQC, medication and service user surveys were now checked with a view to embedding these within care practice.

Not all care plans person-centred. Some had additional information to present a person-centred approach. This had been recognised by the registered provider and a plan of action in place.

We have made a recommendation about the writing of daily records.

Some people commented that some timings of calls were not always on time but that these delays were not excessive and did not have an impact of their support.

People felt safe with the staff team. Staff were aware of the types of abuse that could occur and systems were in place to report these.

Staff provided support in a way which minimised the spread of infection.

The auditing of systems within the service now enabled lessons to be learned.

Staff received the training and supervision they needed to perform their role. New staff had a structured induction process to enable them to prepare for work.

The registered provider operated within the principles of the Mental Capacity Act 2005. The capacity of people was taken into account during the assessment process.

People consented to the support they received.

People felt cared for and felt that staff treated them in a respectful manner. People’s personal information was kept confidential.

Information was available in alternative formats for those with communication needs.

A robust complaints procedure was in place. People told us that they knew how to make a complaint.

The registered provider co-operated with other agencies. The registered provider was aware of the requirements to put their most recent ratings on display.

Care Connect Wirral Limited is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults. Not everyone using Care Connect receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of our inspection, 116 people were supported with their personal care needs by the service. 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.

Although people felt safe with the care they received in their homes; an adequate system had not been established to investigate allegations or evidence of abuse. Risk assessments and guidance was not always in place to ensure specific issues were identified and managed safely. The registered provider had a recruitment system in place but this was not followed and appropriate pre-employment checks had not been completed on newly recruited staff.

Each person using the service had a care and support plan however not all of the risks identified had an action plan record for staff to follow.

The registered provider did not have any formal systems in place for assessing and monitoring the quality of the service. This included the reviewing of medication administration records (MAR charts). This meant that there was a risk that they would not identify where quality and safety were compromised and to be able to respond appropriately to concerns.

People told us staff were kind and caring and sought their consent before providing care. People told us they were treated with dignity and respect and were involved in how their care was planned. Staff promoted people's independence. Staff supported people to meet their nutritional needs. People knew how to raise concerns and a complaints system was in place. The quality assurance system was not effective at identifying concerns or driving improvement.

An induction programme was in place with refresher training to enable staff to work safely and effectively. Staff had the skills to meet peoples’ needs.

During this inspection we found breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Care Connect Wirral Limited is a domiciliary care agency. It offers care and support to 126 people in their own homes including personal care. The agency has offices based within a business park in Ellesmere Port and is registered as a supplier of services to Cheshire and Wirral local authorities. They employ 52 support staff.

This was the first comprehensive inspection of this service.

The service had a registered manager who had been in post since 1993 and is registered with the Care Quality Commission. 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.

At this inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People’s needs were assessed and risk assessments were in place prior to when the service commenced. The needs and risks were reviewed regularly. People’s histories, wishes and preferences were not consistently reflected within their care plans. This meant that staff may not provide support in line with a person’s wishes particularly when they were new to the person. Care plans demonstrated the specific tasks to be undertaken by staff at each visit and were signed by the person receiving the service. Daily records were maintained for each person that showed they had received their care and support.

The registered provider did not have any formal systems in place for assessing and monitoring the quality of the service. This included the reviewing of medication administration records (MAR charts). This meant that there was a risk that they would not identify where quality and safety were compromised and to be able to respond appropriately to concerns.

Staff received training and support to carry out their job and they were provided with further opportunities to develop within their roles. Staff had access to policies and procedures in relation to safe practice. However, the registered provider failed to ensure that staff were observed carrying out support tasks such as medication administration and therefore could not be assured of their competence.

People had no concerns about their safety and the way they were treated by staff. There were systems in place to protect people from abuse which included training for staff and policies and procedures for staff to follow. Staff spoken with demonstrated a good understanding of what action needed to be taken in the event of a person being at risk from harm. Recruitment practices helped ensure that only people suitable to work with vulnerable people were employed by the service.

People felt that they could be better informed about which staff they could expect or if they were running late. However, people told us that the staff completed all of their required tasks. People told us that they had a core team of staff which was good because they got to know each other well. They told us that most staff met their needs and had the right skills to provide their support. The registered provider employed a sufficient number of staff to meet the needs of the people they supported.

Staff were confident about dealing with emergency situations. Records showed they had details of people and services they could contact if they needed advice, guidance or support at any time of the day or night.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that policies and guidance were available to staff in relation to the MCA. Care planning documents showed consideration of the MCA which meant that people’s rights were protected.

People had access to information about how to complain and they were confident about voicing any concerns they had. Complaints were taken seriously and dealt with in a timely way. People’s views about the service had been sought at review and through questionnaires. One relative told us “When I have had cause to complain or raise concerns they have been rectified promptly”.

"Carers are wonderful"

"They are lovely"

"They are very efficient"

"They are top notch"

"There is an occasional problem but it is sorted out"

"They are excellent"

"I thank them for the lovely care they give"

One comment we saw related to newer staff not completing tasks as they should. There was evidence that the manager had sought to resolve this and fed this back to the staff team.

This visit found that the health and wellbeing of people was promoted through the regular review of care plans, the inclusion of people in their care plans and the recognition that risks could adversely affect people using the service. We saw that people were protected from harm through the policies and training that the service provided. Where there was a need for safeguarding investigations to be made, we found that the agency sought to co-operate with local authorities and to take decisive action to ensure that people were safe.

We found that the recruitment process was robust with checks being undertaken to ensure that people were suitable for their role. We saw that the service actively sought the views of service users about their care and adopted the services of an external independent agency to ensure that quality assurance systems were effective. We found that when complaints were raised, these were listened to and acted upon.