Archived: Way Ahead Care - Taunton

Way Ahead Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to older adults, and younger disabled adults. At the time of the inspection approximately 300 people were receiving care in their own homes; the number could vary. 285 people received personal care. This is help with tasks related to personal hygiene and eating.

Some people were living in extra care housing. Extra care housing is purpose built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service. Way Ahead Care – Taunton provided care and support from a housing manager and staff to people living in seven specialist 'extra care' housing.

Not everyone using Way Ahead Care - Taunton receives 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.

People’s experience of using this service and what we found

People were supported with their medicines in the way prescribed for them. However, there were some areas for improvement in the way medicines were recorded. We have made a recommendation to ensure the provider complies with current best practice guidance.

People's individual risks were assessed, and measures were put in place to keep them safe. The management team were reviewing care plans and risk assessments to ensure they provided more detailed information for staff to follow.

As a result of staff recruitment issues, agency staff were used to help ensure expected visits were carried out. People said they preferred staff from Way Ahead Care rather than agency staff, but they understand the current pressures within the sector. The management team had recognised this and had put plans in place to recruit and retain more staff. Staff were recruited safely and knew how to keep people safe from harm and abuse.

People felt comfortable and safe with the staff and said staff treated them with dignity and respect. Many people described staff as caring and friendly.

People had plans of care in place which were reviewed with family members and health and care professionals where appropriate.

Safe practices were followed to help prevent the spread of infection including COVID-19.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were quality checks in place to monitor the quality of services provided. There was a culture of learning from mistakes and the senior management team had an open approach and were keen to provide a good and consistent service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 31 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to the management of the service and the management of people’s medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Way Ahead Care – Taunton on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This is the first inspection after the provider reregistered with the Care Quality Commission.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to older adults, and younger disabled adults. At the time of the inspection 338 people were receiving care in their own homes.

205 of the people receiving personal care were living in extra care housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. Way Ahead Care – Taunton provided care and support from a housing manager and staff to people living in five specialist ‘extra care’ housing. An additional ‘extra care’ house only had care supplied by the provider.

Not everyone using Way Ahead Care - Taunton receives 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.

There was a registered manager in post at the time of the 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. They were supported by a deputy manager.

Most people with specific health conditions had guidance for staff to follow to ensure their needs were met consistently. Staff had received additional training from other health professionals to support these people. People’s medicine was usually administered safely and in line with their needs. Improvements were required to ensure current national guidance was being followed for ‘as required’ medicines and topical creams. Accidents and incidents had lessons learnt identified and action taken.

Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. On one occasion we found the risk assessment had not been updated with a person’s changing needs. People were protected from potential abuse because staff were able to recognise signs and knew how to report it. Most people thought there were enough staff. Some people felt staff did run late.

The provider and manager wanted to provide high quality care for people. There were occasions people were unaware who the management were or they did not receive a response. There was a positive approach to improving the service. Staff felt supported and the management had brought about positive improvements. The management had systems to monitor the quality of the service and made improvements in accordance with people’s changing needs. Some of these were more informal so had not identified minor concerns found during the inspection. They had completed statutory notifications in line with legislation to inform external agencies of significant events.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. When people lacked capacity actions to ensure the statutory principles of the Mental Capacity Act 2005 had not always been recorded. People and their relatives were positive about the food and meals were prepared to meet people’s needs and wishes.

Staff had the skills and knowledge required to effectively support people. People and their relatives told us their healthcare needs were met and staff supported them to see other health and social care professionals. Staff were proactive in identifying when people’s health started to decline.

People and their relatives told us, and we observed that staff were kind and patient. People’s privacy and dignity was respected by staff and their religious needs were valued. When people had specific needs or differences they had been considered by staff. People, or their representatives, were involved in decisions about the care and support they received.

Care and support was personalised to each person which ensured they were able to make choices about their care. People and their relatives knew how to complain. There was a complaints system and complaints had been managed.