We carried out a review of the data available to us about Westminster Homecare Limited – West London on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Westminster Homecare Limited – West London, you can give feedback on this service.
Westminster Homecare Limited (West London) is a domiciliary care agency. It provides personal care to mostly older people living in their own homes. It also supports some adults who are living with dementia and adults who have physical or learning disabilities. At the time of our inspection the service was providing care to 108 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People told us they felt safe. Where there were risks to people’s safety and wellbeing, these had been assessed and the provider had done all that was reasonably practicable to lessen those risks. People received their medicines safely and as prescribed.
People's care and risk management plans set out the care tasks they required help with and these contained personalised information about people and their preferences for how they liked to be supported.
There were robust systems in place to monitor the quality of the service and recognise when improvements were required. The provider was transparent and there was clear communication within the team, so they learnt from mistakes and made improvements when things went wrong.
We received positive feedback from people and their relatives about using the service. People said staff were caring and treated them with dignity and respect.
The provider made sure there were enough staff to support people and staff usually arrived on time at people’s homes. The provider’s monitoring system helped ensure people received all their visits as planned. Staff received induction, training and supervision and felt supported in their roles.
The provider sought feedback from people, relatives and staff and used this to develop the service. People and staff were confident they could raise any concerns they had with the registered manager and felt they would be listened to.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The registered manager and senior staff were responsive to and worked in partnership with other agencies to meet people’s needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 22 January 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure someone would be available when we inspected.
The service was last inspected on 12 May 2016 when we rated the service good in all key questions and overall.
Westminster Homecare Limited (West London) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults including those with physical frailty or memory loss due to the progression of age whilst others were living with the experience of dementia or had mental health needs. At the time of our inspection, there were 172 people using the service. Most people using the service were receiving funding from their local authority, either Hounslow or Ealing, and a few people were funding their own care.
There was a registered manager in post at the time of our inspection. A registered manager 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.
There was a policy and procedures for the management of people’s medicines and staff had received training in this. However, one person who used the service had not received their medicines as prescribed.
There were systems in place to monitor and assess the quality and effectiveness of the service, and the provider ensured that areas for improvement were identified and addressed. However, a medicines audit had failed to identify the issues we found during our inspection.
Compared to the number of calls completed, the number of missed calls was small, but in each case, these were investigated and recorded. The registered manager showed us evidence that a new system had recently been put in place to improve this and prevent further missed visits.
Feedback from people and their relatives was not always positive. Some people said they did not always feel listened to by office staff when they raised concerns. Others told us they were happy and had built a good rapport with the care workers.
There was a complaints procedure in place which the provider followed. All recorded complaints had been addressed appropriately and in line with the provider’s procedures.
The risks to people's wellbeing and safety had been assessed, and there were detailed plans in place for all the risks identified.
Incidents and accidents were recorded and appropriate action was taken. The provider ensured that lessons were learned when things went wrong and put action plans in place.
People and staff were protected from the risk of infection and cross contamination. Staff were issued with appropriate equipment and received training in infection control.
There were procedures for safeguarding adults and the care workers were aware of these. Care workers knew how to respond to any medical emergencies or significant changes in a person's wellbeing.
The registered manager raised safeguarding concerns to the local authority and worked with them to investigate these and take appropriate action.
People's needs were assessed by the provider prior to receiving a service and care and support plans were developed from the assessments. People had taken part in the planning of their care and received regular visits from the care coordinators or the field supervisor.
Most people we spoke with and their relatives said that they were happy with the level of care they were receiving from the service and found the care workers kind and respectful.
The registered manager was aware of their responsibilities in line with the requirements of the Mental Capacity Act (MCA) 2005 and we saw evidence that staff received training in this.
Records showed that, where able, people had consented to their care and support and had their capacity assessed prior to receiving a service from the agency.
The provider employed enough staff to meet people's needs safely and had contingency plans in place in the event of staff absence. Recruitment checks were in place to obtain information about new staff before they were allowed to support people unsupervised.
People's health and nutritional needs had been assessed, recorded and were being monitored.
Care workers received an induction and shadowing period before delivering care and support to people. They received the training and support they needed to care for people.
Staff told us that the registered manager was approachable and supportive. There was a clear management structure, and they encouraged an open and transparent culture within the service. The registered manager felt supported by senior management.
We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure someone would be available.
The service was last inspected on 1 November 2013 and at the time was found to be meeting the regulations we looked at.
Westminster Homecare Limited (West London) is a domiciliary care agency which provides personal care for people in their own homes. At the time of our inspection, there were 178 people using the service. Most people using the service were receiving funding from their local authority, either Hounslow or Ealing, and a few people were funding their own care.
People who received a service were all older people and included those with physical frailty or memory loss due to the progression of age whilst others were living with the experience of dementia or had mental health needs. The frequency of visits varied from one to four visits per day depending on people's individual needs.
There was a registered manager in post at the time of our inspection. A registered manager 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.
The risks to people's wellbeing and safety had been assessed, and there were detailed plans in place for all the risks identified.
There were procedures for safeguarding adults and the care workers were aware of these. Care workers knew how to respond to any medical emergencies or significant changes in a person's wellbeing.
Feedback from people and their relatives was positive. Most people said they had regular care workers visiting which enabled them to build a rapport and get to know them.
People's needs were assessed by the local authority prior to receiving a service and support plans
were developed from the assessments. People had taken part in the planning of their care and received regular visits from the care coordinators or the field supervisor.
People we spoke with and their relatives said that they were happy with the level of care they were receiving from the service.
The registered manager was aware of their responsibilities in line with the requirements of the
Mental Capacity Act (MCA) 2005 and told us that the newer staff had received basic training in this during their induction. They told us they were planning more in-depth refresher training for all staff.
Records showed that people had consented to their care and support and had their capacity assessed prior to receiving a service from Westminster Homecare Limited (West London). The registered manager told us that all the people currently using the service had capacity.
There were systems in place to ensure that people received their medicines safely and the care workers had received training in the management of medicines.
The service employed enough staff to meet people's needs safely and had contingency plans in place in the event of staff absence. Recruitment checks were in place to obtain information about new staff before they supported people unsupervised.
People's health and nutritional needs had been assessed, recorded and were being monitored.
These informed carers about how to support the person safely and in a dignified way.
Carers received an induction and shadowing period before delivering care and support to people.
They received the training and support they needed to care for people.
There was a complaints procedure in place which the provider followed. People felt confident that if they raised a complaint, they would be listened to and their concerns addressed.
There were systems in place to monitor and assess the quality and effectiveness of the service, and the provider ensured that areas for improvement were identified and addressed.
People, staff and relatives told us that the registered manager and senior team were approachable and supportive. There was a clear management structure, and they encouraged an open and transparent culture within the service. People and staff were supported to raise concerns and make suggestions about where improvements could be made.
People told us they were generally happy with the care and support they received. Their comments included 'they are very good, they always help with the things I need' and 'the carer is excellent, I couldn't ask for better.'
We looked at the care plans for 6 people using the service. We saw that the care plans detailed people's needs and the care and support their care workers should provide. The plans were updated regularly and people were involved in reviewing the care they received.
The provider had policies and procedures for safeguarding people using the service. Care workers understood the procedures and were trained to identify possible abuse. The agency cooperated with other agencies to address any safeguarding concerns.
We looked at the personnel files for 6 care workers and saw that the provider had carried out appropriate checks before care workers started to work with people using the service.
There were procedures in place to monitor the quality of the services provided. People told us they were asked about their care and support and they felt they were listened to. People also told us they knew how to make a complaint and they were confident they would be listened to.
People said they were involved in the way their care and support was planned and were able to say how they wanted to be cared for and supported. They were also involved in the review of their care. They informed us that their care workers respected their privacy and dignity. They thought that care workers were well trained and knew how to care for them appropriately. People said they were informed when their care workers were late and alternative arrangements were made if their usual care worker could not visit them.
People reported that they had the necessary information to contact the office if they were not satisfied with their care or worried about their safety and were confident that their concerns would be taken seriously and addressed. Staff however did not always have all the necessary information to enable them to raise concerns if this was needed to safeguard people against the risk of abuse and poor care.
The provider carried out a satisfaction survey, spot checks and telephone surveys of people or their relatives to get feedback about the quality of services provided. The provider however has not ensured that a yearly audit and quarterly audits were completed according to it's quality assurance procedure.