Westminster Homecare Limited – Aylesbury

This inspection took place on 7 and 8 January 2019. It was an announced visit to the service.

We previously inspected the service in September 2017. The service was not meeting all the requirements of the regulations at that time. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions 'safe', 'effective', 'responsive' and 'well-led' to at least 'good'. The action plan was completed and sent to us.

There had been changes to management of the service since the last inspection. A registered manager was in post. This is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People spoke positively about their care workers. Comments included "Staff are friendly and kind. Some carers are exemplary," "Lovely staff, very charming, friendly," "Good service and very good carers," "I've had nothing but kindness from all of them" and "The carers are always very pleasant and we chat."

Staff described improvements to the culture of the service. They told us they received good support. Improvements had been made to staff training. None of the staff had any concerns about the practices they were asked to undertake as part of their duties. They understood about safeguarding people from abuse and said they would report any concerns. People who were supported by the agency told us they felt safe.

Each person had been assessed before they received a service from Westminster Homecare Limited (Aylesbury). Care plans had improved and recorded people's preferences and support requirements in detail. Risk assessments had been written to assess the likelihood of people experiencing any harm or injury. Measures were put in place where risks were identified, to reduce the likelihood of harm.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Some people were supported with their medicines. These were handled safely and appropriate records were kept.

Staff were recruited using robust procedures to make sure people were supported by care workers with the

right skills and attributes. Staff received appropriate support through a structured induction, which included all the training the provider considered mandatory.

People told us there were inconsistencies in when their care workers arrived to support them. For example, some of the feedback we received included "Arrival times can fluctuate within two hours and they never call to say they're going to be delayed," "Forever late with calls" and "Staff arrive at different times, you never know where you are. Always more than half an hour late." We have made a recommendation to improve this area of practice.

People knew how to make a complaint. Their experiences of doing this varied. We have made a recommendation about monitoring responses to people's complaints and concerns.

There were improvements to monitoring of the service, to ensure people received appropriate care and support. This included spot checks of care workers' practice, care reviews and audits.

Records were maintained to a good standard and staff had access to policies and procedures to guide their practice.

The five questions we ask about services and what we found