Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report I Care Domiciliary Care Unit A1 Cook Court Pacific Road Cardiff CF24 5AB Type of Inspection – Focused Date of inspection – Tuesday, 10 February 2015 Date of publication – 30 March 2015 Welsh Government © Crown copyright 2015. You may use and re-use the information featured in this publication (not including logos) free of charge in any format or medium, under the terms of the Open Government License. You can view the Open Government License, on the National Archives website or you can write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] You must reproduce our material accurately and not use it in a misleading context. Page 1 Page 2 Summary About the service I Care is a domiciliary care agency owned by I Care Dom Care Ltd. The agency is registered with Care & Social Services Inspectorate Wales (CSSIW) to provide personal care and support to older people, people with physical disabilities, people with sensory loss/impairment, people with learning disabilities, people with mental health problems and people who are mentally infirm. The registered manager of the agency is Lisa Taylor. What type of inspection was carried out? We (CSSIW) carried out a focussed inspection of this service as part of our programme of annual inspections. We made an unannounced visit to the agency premises on 10 February 2015 where we met with the registered manager. We examined service user records, staff files and other information relating to the running of the agency. What does the service do well? We did not identify any areas of exceptional practice during this inspection. What has improved since the last inspection? The agency had recently moved into Unit A1, Cook Court and we observed that these new premises were more suitable than the company’s previous location. What needs to be done to improve the service? The agency was compliant with the Domiciliary Care Agencies (Wales) Regulations 2004. We would recommend that care is taken when writing service delivery plans to ensure that it is very clear whether care staff are required to prompt or administer medicines to a service user. People applying to work for the agency should be asked to provide a full employment history. If there are any gaps then these should be explored and accounted for. Page 3 Quality Of Life We examined a sample of four people’s care records. Overall we noted that people’s care needs had been clearly identified and plans devised to enable those needs to be met by the agency’s staff. We could see that before commencing work with a person, the agency obtained information about their care needs from the local authority. In addition to this, a nominated person from the agency visits the service user and carries out an assessment of the persons care requirements. From the assessment information, service delivery plans are written which describe the care to be provided by agency staff. The service delivery plans that we looked at were well written, detailed and there was an emphasis on promoting people’s independence and choices. We noted that generally the service delivery plans reflected the information in the care plans provided by the local authority. However in one instance we saw that the local authority care plan was requesting the agency to administer a person’s medicines but the agency’s own service delivery plan stated that staff should prompt medicines. Administering and prompting are not interchangeable words for the same task so we advise that care is taken to ensure that it is very clear what care staff are being asked to undertake. We could see that the agency had completed risk assessments including, where necessary, moving and handling. We noted that the agency also compile a list of any equipment used by the service user such as hoists, profile beds or transfer platforms. Information about the organisation responsible for the maintenance and servicing of the equipment is also compiled. This is good practice. Care staff record the care and support they have delivered in a daily log kept in the service user’s home. We looked at a number of logs and noted that the standard of recording was good. Entries were sufficiently detailed to show precisely the care delivered and we could also see evidence of carers contacting the office if they were unsure of anything or had any concerns about the service user. In one instance there was a record showing that the carer had contacted the service user’s GP. Records on file showed that the agency regularly review people’s care to help ensure that it is meeting the individual’s needs. Furthermore, as part of the agency’s quality monitoring processes, they regularly either visit or telephone service users and/or their families to check that they are happy with the service being provided. We saw that the major themes explored with service users were timekeeping, continuity of care and the response of office based staff to any enquiries made. In the four service user records we looked at, the feedback obtained was generally positive. Page 4 Quality Of Staffing People using the services of I Care can be assured that the agency have a reasonably robust recruitment system in place. This together with training, helps to ensure that staff are suitable to work with vulnerable people. We looked at a sample of three care staff files. We found that the agency had obtained references and Disclosure Barring Service (DBS) checks on the staff. We did note that on all three files that we looked at that there were unexplained gaps in the applicants’ employment history. The agency should request that job applicants provide a full employment history. We saw that all three staff had completed induction and other mandatory health and safety related training. This training was followed up with the staff undertaking shadowing shifts. The records showed that care staff receive regular spot checks by a line manager to ensure that they are working in a competent manner and adhering to the company’s policies and procedures. Page 5 Quality Of Leadership and Management We did not consider the theme of Quality of Leadership and Management on this occasion. Page 6 Quality Of The Environment The agency had recently moved premises and are now located in offices in Cook Court, Pacific Rd, Cardiff. We observed that these premises provided a good base for staff and secure storage for records. Page 7 How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focused inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focused inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under ‘Quality Themes’. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet ‘Improving Care and Social Services in Wales’. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. Page 8
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