The inspection took place on 10 and 15 November 2016 and was announced. The Chinese Wellbeing service were providing care for 27 service users who were all from a Chinese culture, speaking Chinese/Cantonese as their first language at the time of our inspection. They had a complement of 24 staff who spoke Chinese as their first language who were providing care in people’s homes in addition to office staff who consisted of the Chief Executive (CEO), service development manager, registered manager, two senior carers, one care manager, a dementia support champion and an administrator.
There was a registered manager in post at the time of our inspection. 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.
Within the domiciliary care service being offered, people had access to advocacy services, a luncheon club, a personal wellbeing service, a transitional service, mental health and wellbeing service and dementia services such as ‘The Tea House Reminiscence’.
The most striking aspect of this dynamic service was the strong sense of leadership, commitment and drive to deliver a service which improves the lives of people in a fulfilling and creative way. There was effective leadership at differing levels within the service from the top down. The culture was embedded to deliver a service by the Chinese cultural code which was regarded as the “five hearts” which were attentiveness, care, love, endurance and patience.
Staff told us they received supervision on a monthly basis and they received annual appraisals. Staff were well respected within the organisation by senior managers and were being provided with comprehensive training including specialist training. There was a culture of striving for excellence including for staff to reach their maximum potential by achieving in their roles through attending specialist training in areas such as advocacy. The service was making a difference to people’s wellbeing by working well as a team, in harmony with one another sharing the same values and principles. There was a strong caring culture with clear leadership in exploring new innovative ways of providing care in a person centred way.
People were being cared for with a level of support which was above and beyond providing support with task based activities such as washing and dressing. People were receiving a case management model of care which involved the case manager referring people on to the most appropriate services or healthcare professionals with the person’s consent.
The service were being proactive in providing people with a range of information to assist them to make decisions about their health and wellbeing. We found examples were staff had worked with health and social care professionals for the benefit of the person receiving care and were actively contributing to supporting people to attend their health appointments, recording clearly in the records the advice provided by the health care professional in order to support the person to follow the advice given.
People were listened to and their voice was heard in a variety of creative ways such as by people taking part in surveys, reviews, taking part in short films and publications such as the service’s own newsletter. Staff supported people to make decisions for themselves and spoke with people about their wishes and preferences whilst delivering care.
Staff wanted to know if they could improve anything for people and wanted to deliver care which was person centred. Staff were observant and reported health/behaviour changes and were flexible in adapting the way they provided care ensuring they were person centred.
The service actively participated in wider projects and kept up to date with what was going on within the health sector and social care sectors. They were committed to developing a service tailored to meet the specific needs of people; in particular their empathy towards people who were living with dementia was displayed by their efforts and hard work involved in developing a dementia service for people. The staff demonstrated a passion to set up a Tea House Reminiscence session for people who were receiving care and to also access a group which involved people within the Chinese community who were living with dementia coming together as a group.
The benefits of this service were illustrated within a short film which the service compiled to raise awareness. They had arranged for memorabilia to be shipped across from China such as Chinese tea cups, tea pot, books and other items to replicate as much as possible what people would have been used to when living in China. In the short film, people were seen laughing, conversing and reading all through the medium of the Chinese language whilst enjoying a drink of Chinese tea. This was contributing to people’s mental health wellbeing and providing social interaction which was meaningful and person centred.
We found staff had an understanding of safeguarding and were aware of what to do if they wished to whistle blow. The service provided people who use the service with information in their own language about the different types of abuse and who to contact if they needed support. The registered manager was aware of risks within the service and was undertaking analyses of risks. The service had emergency plans in place and took action when they became aware someone was at risk.
People’s care needs were risk assessed with risk management plans in place and support for staff when they needed it. Recruitment checks were carried out and there were a high number of staff who worked within the service who were long term staff within the organisation, providing consistency for people receiving care.
Staff were confident within medication management and were skilled to identify side effects and report them to the General Practitioner. People were supported to seek medical advice and health care professionals input.
Carers prepared freshly cooked food which was important for people who as part of their culture were unable to eat fast food or ready prepared meals which needed warming up.
The service were acting as advisors in some cases for health and social care professionals in trying to meet the needs of people with mental health and physical disabilities who are from a Chinese culture.