Cardiff Council Homecare Service
Transcription
Cardiff Council Homecare Service
Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Cardiff Council Homecare Service Northwest Locality Offices Whitchurch Hospital Whitchurch Cardiff CF14 7XB Type of Inspection – Focused Date(s) of inspection – Monday, 23 March 2015 Date of publication – Monday, 13 April 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 Summary About the service The Cardiff Council Home Care Service is registered as a domiciliary care agency to provide personal care to older people, people with physical disabilities, sensory loss or impairment, learning disabilities, mental health problems, dementia and substance misuse problems. The agency is also registered to provide personal care to children and their families. The agency focusses on providing short term (usually 6 weeks) services to support people in their rehabilitation following hospital discharge and to prevent hospital admission by providing a rapid response to requests for care. Supporting people to regain/maximise their independence is an underpinning principle of all service provision. The agency currently provides a city wide service from two bases in Whitchurch Hospital and in Llanrumney Avenue. The Registered Manager is Glynis Duddridge and the Responsible Individual is Sian Walker. During the inspection, we were informed that the Registered Manager will shortly retire from her employment with Cardiff Council and a new manager, Michael Maguire, will be appointed in her stead. We were informed that applications to CSSIW and the Care Council for Wales for registration have been completed. What type of inspection was carried out? An unannounced, planned and focused inspection was carried out on the 23rd March in accordance with CSSIW regulatory procedures. The following methodology was used to compile evidence for this report: Consideration of information held by CSSIW including the Statement of Purpose and Service User Guide Discussions with a range of service users and their relatives and carers Analysis of care planning documentation in respect of six service users, including initial assessments, service development plans, reviews and risk assessments Analysis of six staff files to consider safe recruitment and access to training and supervision Discussions with three members of staff Consideration of the quality review processes Consideration of complaints and compliments received by the agency and the way in which they were dealt with What does the service do well? The agency provides its services in a dignified and respectful manner that is generally well received by service users and their carers. What has improved since the last inspection? No improvements were noted to have taken place since the last inspection in 2014. Page 2 What needs to be done to improve the service? No issues of non-compliance were noted during this inspection. We did however make the following practice recommendations: There were some inconsistencies in the quality of care planning. We found some documentation identified mutually agreed, person-centred goals whilst others were rather more generic, meaning it was difficult to identify what the service was trying to do. This was discussed with the managers who have agreed to look into the matter Discussion with the managers revealed weakness in understanding of dementia and person centred care planning. This was identified as a matter for improved training and mentoring and is a factor in the first of our practice recommendations above Supervision is inconsistent in frequency and regularity although it is generally of high quality. The managers gave assurances that future changes to the service are expected to release some time to enable supervision to happen on a regular basis and in line with regulatory requirements. The quality assurance system could be improved by identifying realistic targets for performance and developing action points to ensure they are met. Page 3 Quality Of Life Overall, we (CSSIW) found that people using the service can be confident that they will be offered a range of services that maximise their independence and will be supported on a short term basis to enhance their independence by a group of staff who are motivated, appreciated and want to make a positive difference to peoples’ lives. This short-term support helps people to learn or relearn the skills they need to remain in their own home. It focuses on supporting individuals with poor physical or mental health or a disability to live as independently as possible by meeting specific goals, monitoring progress and re assessing their needs as required. People using the service feel they are being listened to and are involved in the planning and delivery of the support they receive. This is because support packages are tailored to meet the needs of the individual and record their progress. The support provided is monitored and reviewed at regular intervals, depending on the needs of the person, this can be daily or weekly during the time the support is in place. People using the service can be confident that staff that support them have been recruited using strict recruitment procedures. This is because six staff files were made available for examination during the visit and were seen to hold the necessary information along with Disclosure and Barring Service checks. Staff spoken with discussed their satisfaction with their role and how they experience job satisfaction. During the visit we were able to speak with three staff who told us that they felt confident in their role and felt supported by the management and fellow colleagues despite the sometimes stressful nature of the job. The staff spoken to told us that they feed back their observations regularly, their views are acted upon and plans are amended as required. The health, rights and best interests of people are safeguarded by maintaining a record of key events and activities carried out as part of the delivery of service. Staff complete a record of their visit and a communication log detailing each person’s progress. The discussions with people who use the service confirm that they are involved in planning and changing their aims and care needs as needed. There is also input from physiotherapists, district nurses and other health professionals as required. Staff told us that they work well with other professionals and can request their input at any time. People experience well being and a sense of achievement when they meet their aims with the support and encouragement of staff. Those experiencing difficulties are helped to develop coping strategies to overcome their problems. The aim is to promote independence, build confidence, improve privacy and encourage the person to be confident to remain in their own home. The people spoken with were very pleased with the service they received and told us that Page 4 staff were very helpful, encouraging and had improved their confidence. Some people no longer need a service because they have achieved their aims and described the service provided as “excellent” and “wonderful.” One person commented that she no longer needs assistance but she misses the staff that used to visit her because they are lovely to talk to. Another commented told us that she had been treated kindly and helped to regain her independence through the care and encouragement of the care workers. Page 5 Quality Of Staffing CSSIW did not consider it necessary to look further at the Quality of Staffing on this occasion although some comments have been made in the Quality of Life section of this report. This theme will be considered in greater detail during future inspections. Page 6 Quality Of Leadership and Management CSSIW did not consider it necessary to look further at the Quality of Leadership & Management on this occasion although some comments have been made in the Quality of Life section of this report. This theme will be considered in greater detail during future inspections. Page 7 Quality Of The Environment This section is not applicable to domiciliary care agencies as the agency provides services in the persons own home. Page 8 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 9