12 June 2018
During a routine inspection
Winsford Network is a domiciliary care service run by VIVO Care Choices Limited. They are registered to provide personal care to adults within their own homes. The service offers support to older people and people with learning disabilities, sensory impairments and physical disabilities.
The service is provided to people living in their own accommodation, rented through a partner landlord. This arrangement is often known as 'supported living'. At the time of our inspection there were 29 people who received a service in this way by 63 staff across seven supported living homes.
The service has a registered manager. 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 a legal responsibility for meeting the legal requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At this inspection we made a recommendation that the registered provider source appropriate training to ensure all staff have an up to date knowledge and understanding of the MCA and DoLS. Staff mandatory refresher training updates also need to be regularly undertaken in accordance with best practice guidelines.
Staff had all completed mandatory training required for their role, however refresher updates were overdue. The registered provider had identified this through their audit processes and had an action plan in place for all staff training to be up-to-date by the end of July 2018.
The Care Quality Commission as required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance in place for the staff in relation to the MCA. The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA). The registered manager had a good understanding of the MCA and all required documentation was in place.
Procedures for the recruitment of staff were robust and this helped to ensure that only staff suitable to work with vulnerable people were employed. An active recruitment process was being undertaken due to a number of vacancies at the service. There was a high level of agency staff usage however where possible the same agency staff were used for consistency. All staff had undertaken a thorough induction process that had included the completion of shadow shifts at the start of their employment. Staff attended team meetings were supported through regular supervision.
The registered provider had policies and procedures in place to protect people from abuse. Staff demonstrated a basic understanding of the different types of abuse and told us they felt confident to raise any concerns. People supported by the service had the opportunity to attend safeguarding training to raise their awareness of what abuse is.
People had their needs assessed prior to being supported by the service. The information from this was used to create individual person-centred care plans and risk assessments. People and their relatives, if appropriate participated in the development of the care plans. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. People's care plans were regularly reviewed and updated when any changes occurred.
The registered provider had comprehensive medication policies, procedures and guidance available for staff to follow. Staff administered medicines at all completed training and had the competency regularly checked. Medicines ordering, storage, administration and disposal were all managed in accordance with best practice guidelines.
The complaints procedure was available and easy read and pictorial formats. People and their relatives told us they felt confident to raise a concern or complaint and believed these would be listened to and acted upon promptly by the registered provider.
The registered provider had up-to-date policies and procedures in place to support the running of the service and these were regularly reviewed.
People spoke positively about the food and told us they were always offered choices of food and drink. Clear guidance was in place for staff to follow when people required support to manage health-related diets.
People told us that they knew most of their staff and had developed positive relationships. People and their relatives said that staff were kind and caring at all times. Staff demonstrated a good understanding of the importance of privacy and dignity, and people told us this was respected.
Activities were available for people to participate in and the management team had developed positive relationships with local community organisations.
The registered provider had a selection of quality monitoring systems in place that were followed by the management team for development and improvement. Audit systems were regularly undertaken as part of the registered providers governance process.