Weston Business Centre (also known as Mashdel Healthcare Services) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. People using the service lived in nine residential houses and ordinary flats across Colchester and the immediate surrounding areas. Not everyone using Weston Business Centre 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. At the time of the inspection the registered provider was providing support to nine people.
Following the last inspection on 29th June 2017 and 4th July 2017, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well led to at least good. At the last inspection we rated both these key questions as requires improvement and identified that the service was breaching regulation 18 as the registered person did not ensure there were sufficient numbers of suitably qualified, competent, skilled and experienced staff deployed in order to meet the provision of the regulated activity. There were not enough staff to ensure all peoples needs were met. This was predominantly noted with three out of 14 people who were receiving 24 hour care packages. Staff were working extremely long hours with no break. We additionally identified that a lack of effective management and a lack of oversight, with no registered manager did not fully ensure the service delivered was safe and continued to improve. This with particular relevance to the monitoring of staff working hours, Systems in place required developing to show how the service was moving forward.
During this comprehensive inspection we found improvements had been made in two key questions and have changed the rating for the domains 'Safe' and 'Well-led' to Good. We have kept the rating for 'Effective',' Caring' and 'Responsive' as Good. The overall rating for the service has improved and changed from ‘Requires Improvement’ to 'Good'.
A registered manager is now in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
We found people who used the service were protected from the risk of harm and abuse because staff had received safeguarding training and they knew what to do should they have any concerns. Staff were recruited safely.
People received their medicines as prescribed and the registered manager had implemented procedures to ensure documentation relating to medicines was robust.
People who used the service had a wide range of support needs. Some people required support from the service 24 hours a day and other people were more independent and received support for just a few hours a day to help with their daily routines. There were enough staff to meet people's needs and new staff had recently been recruited to maintain appropriate numbers of staff.
People are supported to have maximum choice and control of their lives and staff do support them in the least restrictive way possible; the policies and systems in the service do support this practice. We found the registered manager and staff understood their responsibilities under the Mental Capacity Act 2005. They were aware of the need to gain consent when delivering care and support, and what to do if people lacked capacity to agree to it.
People's abilities to make decisions had been assessed and appropriate support had been provided to ensure that their views were taken into account when making decisions. Relatives and other professionals had been involved when important decisions about care had to be made.
Positive and caring relationships had been developed between staff and people who used the service. We saw people were treated with respect and their dignity was maintained. Staff were overheard speaking with people in a kind, attentive and caring way.
Staff supported people to be involved in their care and to make choices about how they spent their time. Wherever possible staff encouraged people's independence and supported them to access the local community.
Care plans contained information on the care people needed and the risks they faced. Staff were aware of people's health care needs and the support they provided helped to maintain them.
Staff liaised with health and social care professionals for advice and guidance when required.
People told us they liked the meals provided and were offered support to prepare their own meals when they wished to do this.
Staff training and the on-going support staff received from the management team meant that the care provided was calmly delivered, safe and effective.
There was a formalised quality monitoring system that ensured people's views were listened to, any complaints were addressed, audits were completed and checks were carried out on staff practices and performance.
Further information is in the detailed findings below