Care at Home Group Cheshire West and Wirral

We assessed 8 quality statements under this key question. Our rating for this key question has improved to good. Overall, we found the service was keeping people safe. However, feedback was mixed about staffing arrangements. Some people felt they were supported to manage risks and to keep safe. Others felt that calls time were not always as expected, and changes in staff impacted on how effective the support was. Feedback indicated some staff had not always followed guidance for the use of PPE. There were systems in place to ensure concerns relating to abuse were reported. The provider and new registered manager were focused on learning lessons from any incidents and sharing lessons to make improvements. Systems were being embedded to ensure there were enough suitably qualified, skilled, and experienced staff and they were recruited safely. Managers were working with partners to provide safe pathways for people. The provider had made improvements in relation to the safe management of medicines.

We assessed 6 quality statements under this key question. Our rating for this key question has improved to good. Overall, the provider had systems in place to help staff to deliver care to people in line with legislation and good practice standards. Since our previous inspection, the provider had taken action to improve how the service worked together and with others to support people, including ensuring all staff training and supervision was undertaken in line with policy. People’s needs were assessed and their care plans were built around their needs. Care plans contained information to help staff understand the person, including their support and health needs. Processes were in place to ensure people's rights and wishes were respected.

We assessed 3 quality statements under this key question. Our rating for this key question has deteriorated to requires improvement. This was because we received feedback from people in relation to the care provided not always supporting their staffing preferences and it not always being easy to give feedback. Some people said frequent staff changes had impacted on them. They did not know whether their care had been reviewed and were not always able to get through to the office. Managers had acted since our previous inspection to focus on people’s preferences and timings of their care calls, they were also undertaking quality reviews. This was an improving picture but needed to be fully embedded.

We assessed 7 quality statements under this key question. Our rating for this key question has improved to good. The provider had systems and processes in place to monitor the quality of the service. There had been a period when governance systems had not been used effectively, however the provider had addressed and was monitoring this. There had been a period of recovery and improvements were being built upon. At the time of the site visit there was a registered manager in post, who was knowledgeable about the people supported and were clear about the areas they needed to focus on to develop the service. However, whilst we have been preparing our report, the provider has advised that the registered manager has left the service. A new manager has since been appointed, who will be applying to register. A wider management support team had been recruited. We found managers needed to embed systems to promote a shared strategy and culture. Feedback indicated the provider was supportive and inclusive, making reasonable adjustments to support the various needs of staff where required. During our assessment we identified an issue in relation to the provider's registration which we are dealing with through a separate process.