We carried out a review of the data available to us about S & W Independent Living on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about S & W Independent Living, you can give feedback on this service.
S & W Independent Living is a domiciliary care agency proving care and support to people in their own homes in the community. The service provides support to predominantly older 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, eating and medication. Where they do we also consider any wider social care provided.
On the day of our inspection 66 people were using the service.
People’s experience of using this service:
People and relatives we spoke with told us staff were excellent and made them feel safe. Staff understood safeguarding and whistleblowing procedures. We found adequate staff were employed to meet people’s needs. The recruitment process was robust to ensure only staff suitable to work with vulnerable adults were employed. The registered manager promoted a focus on openness and transparency. This ensured staff learned when things went wrong. Accidents and incidents were monitored to enable positive risk taking. People were protected by the prevention and control of infection. Medication systems were in place and followed by staff to ensure people received their medicines as prescribed. Documentation to improve systems was being implemented at the time of our inspection.
Staff were extremely knowledgeable about people needs, people told us the care provided was person-centred and individualised. Staff said training was good and kept their knowledge up to date. Staff were supervised and supported. 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 who required support with meals were supported to be able to receive a balanced diet. People had access to health care professionals, staff worked closely with professionals to ensure people's needs were met. Professionals we spoke with told us the care provided was excellent.
When staff engaged with people they were kind and caring and compassionate. People told us the staff were fantastic. People were involved in their care planning to ensure their decisions and choices were reflected. Staff, people who used the service and health care professionals we spoke with told us the communication was good. Staff told us this was one area that had greatly improved. People told us they were listened to and any issues were resolved immediately.
People told us they were supported by the same group of staff, which ensured consistency. People told us staff were flexible and their care was consistently delivered to meet their needs and choices. People received care that was responsive to their needs. Staff understood people's needs, including social, cultural, values and beliefs. One person said, “The staff are so good, [family member] wouldn’t still be at home if it wasn’t for the care staff.”
People were supported at the end of their life to have a comfortable, dignified and pain free death. The agency worked closely with health care professionals and provided outstanding end of life care. They also worked closely with the local hospice to ensure all aspect of end of life care were identified. The staff ensured people and their families wishes were explored and plans developed so these were met. Staff were extremely passionate to ensure all people's needs were met and wanted to provide the highest possible quality of care including supporting family members.
The service had a management team who conducted a range of audits in areas such as, medicine management, health and safety, care plans and daily records documentation. We found the monitoring was effective. For example, the care coordinator had identified the need to improve documentation in medicine management this was being implemented at the time of our inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
At the last inspection the service was rated Good (report published 30 March 2017).
Why we inspected:
This was a planned inspection based on the previous rating.
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.
The provider was given notice of the inspection, as this is a community based service where staff were often out during the day and we needed to make sure that someone would be available to meet us. The service was last inspected in 2014 when it was compliant in all areas inspected.
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.’
The service was safe. People were protected from the risk of harm and staff were trained in how to recognise abuse and report any concerns to the appropriate authorities. Risks to people were identified and appropriate management plans put in place to reduce the risk of harm to people. Accidents and incidents were reported and analysed and action taken to reduce the risk of similar incidents reoccurring.
People received copies of rotas each week so they knew who to expect at each visit. Environmental risk assessments were in place to manage the risks associated with staff providing a service in remote locations. There were contingency plans in place to enable the service to keep running during unexpected weather or travel incidents.
People were cared for by staff with the skills, knowledge and support to carry out their role effectively. Staff had access to information training and support to enable them to develop their practice and improve the care experience for people. Staff sought consent from people before caring for them. People were supported to maintain a healthy diet and nutrition and fluid charts were maintained where needed to keep people healthy. People were supported to access community health services and received ongoing health care from appropriate professionals.
People were generally happy with the care they received from staff; who they described as very caring and kind. People told us that most staff were able to build respectful, caring relationships with them. However, some people were unhappy with the quality of care from a minority of staff; we found this was particularly relevant to the people who did not receive regular carers for their visits.
Some people were not happy with the timing of their calls. Calls were generally allocated within a time frame rather than fixed timing. Some people felt this time frame was too long, particularly for early morning or evening calls when they were either waiting to get up in the morning or having to go to bed earlier than they would prefer.
We recommended the provider looks at how they plan the rota, how they allocate care staff to individual people and how calls times are managed. They should also consider how all staff are supported to develop their caring and people skills, which in turn will enable them to improve their practice and the care experience for people.
The provider did respond where possible, to gender specific requests, with male and female carers. There was a complaints policy in place and people told us they knew how to use it. People were also consulted about the quality of the service and we saw the results of the latest ‘customer survey’ on display in the office and were discussed by staff in team meetings.
The registered manager was present throughout the inspection and spoke passionately about their plans for the service and the development of the staff. Staff were supported to contribute to service improvements and develop in their roles. There was a good management structure in place, with seniors being delegated responsibility for supervising staff and reviewing care plans. There were quality assurance systems in place which identified areas for development which were fed into the overall improvement plan. The registered manager had worked with local commissioners and referrers to ensure that only appropriate referrals were made. This led to a reduction in the time taken from referral to start of care and improved access to the care people needed.