Westwood Homecare (NorthWest) Limited Stockport

Updated 19 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector. Following the visit to the location office, an Expert by Experience completed telephone calls to people and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day. Inspection activity started on 11 April 2023 and ended on 18 April 2023. We visited the location’s office on 11 April 2023 and 12 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the 2 local authorities, professionals who worked with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed a range of records. This included 3 people's care records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, were reviewed. We spoke with 6 people who used the service and 8 relatives about their experience of the care provided. We spoke with 13 members of staff including the registered manager, the compliance manager, the deputy manager, the training manager, the operations manager, care co-ordinator, medicines auditor, care staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 19 May 2023

About the service

Westwood Homecare is a domiciliary care service providing personal care to people in their own homes. At the time of our inspection there were 250 people receiving personal care. 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

Risk management plans were not always in place to guide staff to provide care to people with specific needs in the safest way possible. Medicines were not always managed safely. People were cared for by staff who understood how to safeguard people and how to report any concerns. Staff had undergone safe recruitment checks prior to working at the service. We were assured the service employed safe and effective infection prevention and control practices.

Staff received a programme of induction, training and supervision. People were supported to access a wide range of health care professionals to ensure they received appropriate and timely support. People were mostly supported to have maximum choice and control of their lives and staff mostly supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, we have made a recommendation about capacity assessments and staff training.

People and their loved ones told us staff were caring and kind and mostly treated them with respect. Staff had a good understanding of how to support people in a way that promoted their independence and respected their privacy and dignity. We have made 1 recommendation about staff language barriers and a 1 recommendation about people’s gender preferences.

Care plans were person-centred and written with involvement of people and their loved ones. However, the service had suffered a complete failure of the electronic care system for several weeks and staff only had access to people’s paper care plans in their homes.

Systems and processes to ensure oversight of the safety and quality of the service were not always effective. Audits completed had not always identified the concerns we found on inspection. We identified 2 continued breaches of regulations. The management team acknowledged our concerns and were quick to take action and provide assurances when we fed back our findings during and after the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 29 June 2021) and there were breaches of regulation. 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 the provider remained in breach of regulations. This service has been rated requires improvement for the last 2 consecutive inspections.

At our last inspection we recommended that the provider review the deployment of staff to ensure consistency and timeliness of calls. At this inspection we found some people still had concerns about consistency of staff and timeliness and length of calls.

At our last inspection we recommended that the provider review their recruitment practices. At this inspection we found improvements had been made to safe recruitment procedures.

Why we inspected

The inspection was prompted in part due to concerns received about staffing, call times and safeguarding concerns. A decision was made for us to inspect and examine those risks.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westwood Homecare (NorthWest) Limited Stockport on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to people’s individual risk management, medicines management and governance at this inspection. We have made 1 recommendation about staff language barriers, 1 recommendation about people’s gender preferences and 1 recommendation about mental capacity assessments and staff training.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.