The inspection of Westhope Care Limited – 11 Kings Court took place on 4 April 2017 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service; we needed to be sure that someone would be available in the office.The service is a domiciliary care agency. The agency provides services that are based in a person's own home and in supported living services in the community. The supported living service is provided to people in order to promote and maintain their independence. People's care and housing are provided under separate agreements; this inspection looked at their personal care and support arrangements. At the time of our inspection, the agency was providing a service for 22 people with a variety of care needs, including people living with a learning disability or who have autism spectrum disorder. Seven people were in receipt of personal care. The agency was managed from an office based in Horsham, West Sussex.
At the time of the inspection, there was a registered manager at the service. 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 on 15 February 2016, we identified one breach of Regulation associated with Fit and proper persons employed. Whilst identity and security checks had been completed for new staff, full work histories had not always been obtained and gaps in the employment history of some staff had not been accounted for. At this inspection, we found that the actions had been completed and the provider had met all the legal requirements. Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at the service. There were sufficient levels of staff to protect people's health, safety and welfare in a consistent and reliable way.
At the last inspection on 15 February 2016, we recommended the provider seek good practice guidance in relation to recording the administration of medicines in people's own homes. People's medicines were administered by staff that were trained to do so. However, improvements were needed in relation to the recording of medicines. Following the last inspection, the provider wrote to us to confirm that they had addressed these issues. At this inspection, we found policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed safely.
At the last inspection on 15 February 2016, we found the delivery of care was tailored and planned to meet people's individual needs and preferences. People told us they were supported to participate in activities of their own choice however; staffing levels had limited the opportunities for some people to participate in activities they had planned for. This was an area of practice that we identified as needing to improve. At this inspection, we found that the good level of person centred care and sufficient numbers of staff meant people led independent lifestyles, maintained relationships and were fully involved in the local community.
Risks to people's wellbeing and safety had been effectively mitigated. We found individual risks had been assessed and recorded in people's support plans. Examples of risk assessments relating to personal care included moving and handling, nutrition, falls and continence support. Health care needs were met well, with prompt referrals made when necessary.
People told us they felt safe receiving the care and support provided by the service. Staff understood and knew the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk.
The management team and staff had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They had made appropriate applications to the relevant authorities to ensure people's rights were protected.
People were enabled to choose their own food and drink and were supported to maintain a balanced diet where this was required.
People said staff were caring and kind and their individual needs were met. Staff knew people well and demonstrated they had a good understanding of people's needs and choices. Staff treated people with kindness, compassion and respect. Staff recognised people's right to privacy and promoted their dignity.
Care records contained detailed, person centred information to guide staff on the care and support required and contained information relating to what was important to the person. These were reviewed regularly and showed involvement of people who used the service or their relatives.
Staff felt supported by management, they said they were well trained and understood what was expected of them. Staff were encouraged to provide feedback and report concerns to improve the service.
There was a complaints policy and information regarding the complaints procedure was available. Complaints were listened to, investigated in a timely manner and used to improve the service. Feedback from people was positive regarding the standard of care they received.
The registered manager had developed an open and positive culture, which focussed on improving the experience for people and staff. She welcomed suggestions for improvement and acted on these. Staff were supported and listened to by the registered manager and were clear about their responsibilities.
There was an effective quality assurance system. Audits were analysed to identify where improvements could be made and these were implemented. There was an on-going development plan for the service to ensure it continued to develop and sustain improvements.