The Wilf Ward Family Trust Domiciliary Care Scarborough was rated Good across all five key questions at this October 2019 inspection, maintaining its previous Good overall rating. The service demonstrated strong person-centred practice, safe medicines management and effective staff training, with only a minor recommendation to improve mental capacity assessment records.
Concerns (2)
minor
Record keeping
: “Records did not always show how and when people's mental capacity had been assessed.”
minorConsent / capacity: “We recommend the provider develops more detailed records in relation to mental capacity assessments and best interest decisions.”
Strengths
· Person-centred culture with people actively involved in shaping and improving the service through meetings, surveys and engagement groups
· Staff were well trained, supervised and appraised, with access to a wide range of training and regular supervisions
· Medicines managed and administered safely with staff competency checks and audits
· Risk assessments supported positive risk-taking and were regularly reviewed and updated
· People supported to access a wide range of activities and pursue hobbies and interests
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
caring: Ensuring people are well treated and supported; respecting 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 ensure people have choice and controlGood
responsive: Supporting people to develop and maintain relationships and follow interestsGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
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: Working in partnership with others; engaging and involving people using the serviceGood
The Wilf Ward Family Trust Domiciliary Care Scarborough was rated Good overall following an August 2016 inspection of this supported living service for adults with learning disabilities and/or autism, with a Requires Improvement rating for Safe due to a prior breach of regulation where risk assessments were insufficiently robust — resulting in a service user death on holiday — though remedial action had been taken by the time of inspection. All other key questions were rated Good, reflecting strong person-centred care, effective staffing, training, and leadership.
Concerns (3)
criticalCare planning: “the documentation was not robust enough to ensure all known or potential hazards were assessed and plans put in place to reduce the likelihood of harm to a person”
criticalGovernance: “the provider's systems around risk management had not been robust enough and did not include thorough risk assessment when a person went on holiday”
moderateIncident learning: “The provider had not recognised this and this had placed people at risk of harm. Once alerted to this the provider had responded and implemented a new system”
Strengths
· Medicines were safely handled using a monitored dosage system and staff received training before administering medicines
· Sufficient staffing levels with safe recruitment practices including DBS checks and references
· Comprehensive and up-to-date training across mandatory and specialist areas including learning disability, MCA, DoLS, and end of life care
· Staff received regular supervision, appraisal and one-to-one meetings supporting their development
· Person-centred care plans with detailed individual needs, preferences and regular reviews involving people
Quality-Statement breakdown (21)
safe: Risk assessment and managementRequires improvement
safe: SafeguardingGood
safe: Staffing levels and recruitmentGood
safe: Medication managementGood
safe: Infection controlGood
effective: Staff training and developmentGood
effective: Supervision and appraisalGood
effective: Mental Capacity Act and DoLSGood
effective: Nutrition and hydration
Good
effective: Healthcare accessGood
caring: Dignity, respect and compassionGood
caring: Involvement in care decisionsGood
caring: Relationships and communicationGood
caring: End of life careGood
responsive: Person-centred care planningGood
responsive: Activities and community engagementGood