Westminster Homecare Limited (Forest Hill)

Updated 17 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28 March and 5 April 2018. We gave the service 48 hours’ notice of the inspection visit because it is a domiciliary care agency and the manager is often out of the office supporting staff or providing care. The manager knew we would be returning for the second day. We visited the office location to see the registered manager and to review people’s care records and the key policies and procedures.

Two inspectors and three experts by experience carried out this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we looked at information we held about the service. We reviewed notifications sent to us by the service. A notification is information about important events that occur in the service, which the provider is required to send us by law. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

At the time of the inspection, we spoke with the registered manager, deputy manager, training manager and five care workers. We reviewed care records for 10 people, their medicines records and 10 staff files. We looked at other records relating to the management, leadership and monitoring of the service.

After the inspection, we spoke with 20 people using the service and five relatives. We asked for feedback from representatives of local health and social care service teams for their feedback.

Updated 17 May 2018

This inspection of Westminster Homecare Limited (Forest Hill) took place on 28 March and 5 April 2018 and was announced. This service is a domiciliary care agency.

It provides personal care to people living in their own homes. It provides a service to older and younger disabled adults. Not everyone using Westminster Homecare Limited (Forest Hill) receives a regulated activity; 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 611 people were using the service. This included people living in Bromley and Croydon, Lambeth, Lewisham and Southwark. At the time of writing this report the registered provider had made changes in the service provision with the relocation of services for people who lived in the London boroughs of Croydon and Lambeth. The service was now providing services to 449 people who live in the London Boroughs of Bromley, Lewisham and Southwark .

Westminster Homecare Limited (Forest Hill) had 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.

This is the first inspection at this service since their registration on 18 January 2017 with the Care Quality Commission.

The registered manager and staff understood the principles of safeguarding people from abuse. There were safeguarding policies and procedures that staff used to keep people safe from harm and abuse. Staff understood the reporting process and reported allegations of abuse to the registered manager and local authority team.

Staff completed risk assessments for people. Risk management plans were developed from the risk assessments and used by staff to reduce risks to their health and well being. Systems in place were used to log and monitor accidents and incidents with actions staff took to reduce the risk of this recurring.

Assessments were person centred and included information people provided. Care plans included information about people's health and care needs, histories including their backgrounds and the care required to meet those needs. People had their care and support provided flexibly which took into account people’s choices and care decisions. People received care and support that met their needs at the end of their lives.

Staff administered people’s medicines as required. Staff had their medicine administration competency assessed to ensure they were safe to do this task.

There was sufficient staff to provide care and support for people. People who required two members of staff to support them had this available so they had their care safely. The registered provider used safer recruitment processes to recruit suitable skilful staff to work with people using the service.

Staff had support through induction, training, supervision and appraisal. Staff explored their training, professional and personal development needs and The provider took action to resolve any concerns with staff performance

The registered manager and staff understood the Mental Capacity Act 2005 (MCA). Staff had insight into the MCA through training they completed. MCA training was made available for all staff. People were supported to have maximum choice and control of their lives and staff provided care in the least restrictive way possible for people. The policies and systems in the service supported this practice. People gave their consent to staff before staff provided care and support

People had meals they enjoyed and which met their individual preferences. Shopping tasks were completed by staff when this was required.

People’s care needs were met by health care services. Staff made referrals for health care advice to health care professionals when people’s care needs changed.

People said staff were kind and helpful to them and provided care in a dignified manner. Staff demonstrated respect for people while protecting their privacy when providing personal care.

Staff followed infection control procedures and had access to personal protective equipment to use to reduce the risk of infection.

People contributed to their assessment of their needs. Their care and support were reviewed on a regular basis to ensure people’s needs continued to be met by staff.

A complaints system was available for people to make a complaint about the care they received. The registered manager followed a process for the investigation and responding to a complaint.

There was an organisational system that identified staff roles and leadership structures. Staff understood their role within the service so they were able to carry out their jobs effectively.

Staff had developed partnership working with health care professionals who helped improve the outcomes of people’s health and well being.

The registered manager monitored and reviewed the quality of the service. People and staff provided their feedback and made suggestions to the service. A plan of action was developed to improve quality.

The registered manager was able to fulfil the requirements of their registration with Care Quality Commission (CQC). The service informed CQC of concerns as required by law.