Archived: Westwood House

This was an announced inspection carried out on the 07 April 2015.

Piramid Care Service is a domiciliary care service based at Salford Quays, Manchester. It provides personal care for a range of people living at home. The service provides supported living; community based home care and 24 hour care packages for complex health care needs, challenging behaviour and/or autistic spectrum disorder.

There was a registered manager in place. 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 the last inspection carried out in April 2013, we did not identify any concerns with the care and support provided to people by the service.

We looked at the training, learning and development needs of individual staff members. Supervisions and appraisals enabled managers to assess the development needs of their staff and to address training and personal needs in a timely manner. We found limited information that formal supervision and appraisals had been undertaken.

We looked at the staff supervision policy which indicated formal supervision would take place at least once in every quarter. From reviewing records we found this was not happening. One member of staff told us; “I do have supervision with the manager and regular informal contact. It is not recorded as far as I’m aware.” Another member of staff said “I don’t really have any one to one supervision, but if I need anything I give them a bell.”

We spoke to the manager about these concerns. They confirmed that whilst supervision did take place it was informal, inconsistent and not recorded. They accepted that improvements were required in line with their supervision policy.

This is a breach of Regulation 18 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to staffing, because staff did receive appropriate ongoing or periodic supervision and regular appraisals to support them in their role.

We found the service did not have systems and processes such as regular audits of the service provided to assess, monitor and improve the quality and safety of the service.

In relation to the competency of staff administrating medication and meeting other support needs, we found that no competency or spot checks had been undertaken by management to ensure staff were delivering services safely and correctly. The manager told us that checks were undertaken, however no formal process existed for recording such quality assurance checks.

Though people told us they would not hesitate to contact the service if they had any concerns, it was not clear to us how the service responded to individual concerns and complaints. It was also not clear to us how the service used such information to make improvements and demonstrate that they have been made. The service was unable to demonstrate how they regularly sought the views of people who used the service and took regard of any complaints, comments and views made. For example, we found no satisfaction questionnaires had been circulated to people who used the service, relatives and health care professionals to seek feed-back on the quality of the services provided.

This was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to good governance. The registered person did not have appropriate arrangements in place to monitor the quality of service or regularly seek the views of people who used the service.

You can see what action we told the provider to take at the back of the full version of this report.

People told us they or they loved ones were safe and they trusted staff coming into their homes. One relative told us; “We are very happy. They give us the care and support we need. All carers have had training to meet our daughter’s specialist needs.”

During our inspection, we checked to see how the service protected people against abuse. We found suitable safeguarding procedures in place, which were designed to protect vulnerable people and children.

We looked at how the service managed risk. We found individual risk assessments had been completed for each person and recorded in their care file.

We looked at how the service managed people’s medicines and found that suitable arrangements were in place to ensure the service was safe.

There was a staff induction programme in place. This provided staff with an insight into working for the company when they first commenced employment. Staff confirmed that when they commenced employment with the service they underwent an induction course.

Staff told us they felt supported by the service and received regular training to support them in their roles. Comments included; “Training is excellent and I get enough.” “ Yes its good especially the behavioural course. There’s lots of training.” “I feel valued and supported by the manager who responds to any concerns we have. They manage the service very well.”

We spoke with staff to ascertain their understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DolS). A number of staff were able to confirm some training in the mental capacity act though training records indicated no training had been delivered by the service. The manager was able to tell us that as a result of her recent experiences with a DolS application and the MCA, they had arranged training with an independent provider for all staff.

People and relatives told us the service was professional, kind and caring. One person who used the service said “Yes, staff are very kind and treat me very well. I am happy with what they do for me. They are very good to me.” A relative of a person who used the service told us; “Really excellent interaction with the carers, they are our choice and are really caring. The team we have are absolutely wonderful.”

Each person we spoke with confirmed staff always treated them with dignity and respect when care and support was provided. Staff we spoke with highlighted the importance of treating people in a manner they or they families would want to be treated.

We found people who used the service had care plans in place with copies held at both the head office and in their homes. The structure of the care plan was clear and easy to access information. Staff told us that before they started with a new client they would read the care plan to ensure they knew the individual needs of the person.

We found the service was involved in regularly monitoring people’s health and worked well with other health care professionals.

Relatives and people who used the service confirmed that the service was responsive to people’s changing needs. One relative told us; “They are very responsive to any concerns I or my husband has and they always respond straight away. They take account of any concerns we have.”

Staff told us that they felt valued by the management and spoke favourably of the leadership provided. One member of staff told us; “No concerns for the way the service is managed, I feel supported and valued.”