SW Homecare Agency achieved a Good rating across all five key questions at this January 2023 inspection, having improved from Requires Improvement following breaches of regulations 9, 12 and 17 identified in 2019. The service demonstrated well-embedded risk management, personalised care planning, safe recruitment, and a reflective governance culture with no ongoing regulatory concerns.
Strengths
· Significant improvements since previous Requires Improvement rating, with all prior regulatory breaches resolved including regulations 9, 12 and 17.
· Robust risk assessments regularly reviewed and updated with clear control measures for care workers to follow.
· Safe recruitment practices including DBS checks, employment history review and references.
· Staff complete Care Certificate on induction and receive ongoing training, regular supervision and yearly appraisals.
· People and relatives report high satisfaction; staff described as kind, punctual and professional.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
SW Homecare Agency was rated Requires Improvement overall following a March 2019 inspection, with three regulatory breaches identified under Regulations 9, 12 and 17 relating to person-centred care, safe care and treatment, and good governance. Key failings included insufficiently detailed care plans, incomplete risk assessments, ineffective quality audits, and failure to apply the Mental Capacity Act correctly, despite strengths in staff training, recruitment, and caring attitudes.
Concerns (8)
criticalCare planning: “the care plans provided insufficient detail to give care workers the information they needed to provide personalised care and support that was consistent and responsive to people's individual needs.”
criticalGovernance: “Quality audits were not effective as they had failed to identify the issues we have highlighted in this report.”
criticalRecord keeping: “in some files no risk assessments had been completed or updated to identify what, if any, action care workers should take to minimise risks.”
criticalConsent / capacity: “a care plan for one person whose mental capacity was in doubt did not contain decision specific mental capacity assessments and best interest decisions regarding consent.”
moderateStaff competency: “medicines competency assessments were not in place to ensure care workers were assessed as competent to support people with their medicines.”
moderateComplaints handling: “Three formal complaints had been logged, all regarding staff punctuality... there was no evidence of how the complaints had been used to improve the service.”
moderateIncident learning: “There was a lack of systems in place to enable learning and improvement of performance... no action had been taken to address a concern that had been raised regarding staff punctuality.”
minorPerson-centred care: “records reviewed did not contain information highlighting people's diversity, including cultural needs. Therefore, there was a risk that care needs might have been omitted.”
Strengths
· People told us that they felt safe receiving care from care workers and relatives confirmed no concerns about safety.
· Safe recruitment procedures were in place with appropriate pre-employment checks including DBS, references and proof of identity.
· Care workers had completed induction, essential training and regular supervision and appraisals.
· People's privacy, dignity and independence were respected and promoted by care workers.
· The registered manager was described as approachable and supportive by both staff and relatives.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyRequires improvement
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Staff support: induction, training, skills and experienceGood
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effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
caring: Ensuring people are well treated and supported; equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to meet people's needs, preferences, interests, communication and give them choice and controlRequires improvement
responsive: End of life careNot rated
responsive: Improving care quality in response to complaints or concernsRequires improvement
well-led: Continuous learning and improving careRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Planning and promoting person-centred, high-quality care and supportRequires improvement