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
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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.
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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.
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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
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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.
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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.
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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.
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Quality Of The Environment
This section is not applicable to domiciliary care agencies as the agency provides
services in the persons own home.
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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.
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