Walker & Harrison Care, a domiciliary care service supporting 21 people, was rated Good overall at its first inspection, with people and relatives extremely positive about kind, person-centred and end-of-life care. Well-led was rated Requires Improvement due to gaps in all audits, weak governance oversight and recommendations made about recruitment record-keeping and staff supervision.
Concerns (8)
moderate
Governance
: “There were gaps in all audits reviewed. They needed to be widened in scope and further embedded to support continual improvement of the service.”
moderateGovernance: “Quality improvement systems including audits in all areas needed to be further improved and embedded to ensure a system of continual improvement and learning took place.”
moderateLeadership: “Leaders oversight of the service needed to be more robust to support the governance of the service.”
moderateLeadership: “Leaders needed to be more familiar with their policies to guide the delivery of the service to ensure governance procedures were effective.”
moderateSupervision / appraisal: “Supervision, checks of practice and observations needed to take place more regularly.”
minorStaff training: “Some mandatory training needed to be completed, actions were in place to address this.”
minorOther: “Staff were recruited safely, however recruitment records needed further improvement... We recommend more robust procedures for overseeing recruitment are embedded.”
minorMedication management: “Some medicine administration records needed further information which was addressed during the inspection following feedback.”
Strengths
· Staff were kind, caring and compassionate and went the extra mile for people, leading to positive outcomes.
· End of life care delivery went above and beyond to support people at the end of their lives.
· Person-centred care respected privacy, dignity and gave people maximum control over their lives.
· Diverse workforce with embedded diversity strategy actively promoting equality and inclusion.
· Strong safeguarding practices with people reporting they felt safe and trusted the service.
Quality-Statement breakdown (20)
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Preventing and controlling infectionNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough; working with other agencies; supporting people to live healthier livesNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles; duty of candour; continuous learning and improving careNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersNot rated