Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection report Domiciliary care agency Age Concern Gwent 12 Baneswell Road Newport NP20 4BP Date of publication 14 July 2011 You may reproduce this Report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of Welsh Ministers.
Care and Social Services Inspectorate Wales South East Wales 6th Floor Civic Centre Pontypool Torfaen NP4 6YB 01495 761200 01495 761239 Name of agency: Age Concern Gwent Contact telephone number: 01633 763330 Registered provider: Registered manager: Age Concern Gwent Eileen Powell and David Liles Category: Agency>200hrs e.g. Large agency (200 hours and over) Small agency (up to 199 hours) Supported housing Dates of this inspection year: April 2011 to: March 2012 Dates of other relevant contact since Date of this inspection 10 June 2011 last report: Service user visits 19 June 2011 Date of previous report publication : 16 May 2010 Inspected by: Lay assessor: Other regions contributing to this report: Helen Ford None None Page 1
Introduction This report has been compiled following an inspection of the service undertaken by the Care and Social Services Inspectorate for Wales (CSSIW) under the provisions of the Care Standards Act 2000 and associated Regulations. The primary focus of the report is to comment on the quality of life and quality of care experienced by service users. The report contains information on how we inspect and what we find. The report is divided into distinct parts mirroring the broad areas of the National Minimum Standards. CSSIW`s inspectors are authorised to enter and inspect regulated services at any time. Inspection enables CSSIW to satisfy itself that continued registration is justified. It also ensures compliance with: Care Standards Act 2000 and associated Regulations whilst taking into account the National Minimum Standards. The service`s own statement of purpose. At each inspection episode or period there are visit/s to the service during which CSSIW may adopt a range of different methods in its attempt to capture service users` and their relatives`/representatives` experiences. Such methods may for example include selfassessment, discussion groups, and the use of questionnaires. At any other time throughout the year visits may also be made to the service to investigate complaints and to respond to any changes in the service. Readers must be aware that a CSSIW report is intended to reflect the findings of the inspector at a specific period in time. Readers should not conclude that the circumstances of the service will be the same at all times. The registered person(s) is responsible for ensuring that the service operates in a way which complies with the regulations. CSSIW will comment in the general text of the inspection report on their compliance. For those Regulations which CSSIW believes to be key in bringing about change in the particular service, they will be separately and clearly identified in the requirement section. As well as listing these key requirements from the current inspection, requirements made by CSSIW during the year, since the last inspection, which have been met and those which remain outstanding are included in this report. The reader should note that requirements made in last year`s report which are not listed as outstanding have been appropriately complied with. Where key requirements have been identified, the provider is required under Regulation 23B (Compliance Notification) to advise, in writing, the appropriate regional office of the completion of any action required by CSSIW. The regulated service is also responsible for having in place a clear, effective and fair complaints procedure which promotes local resolution between the parties in a swift and satisfactory manner, wherever possible. The annual inspection report will include a summary of the numbers of complaints dealt with locally and their outcome. Page 2
CSSIW may also be involved in the investigation of a complaint. Where this is the case CSSIW makes publicly available a summary of that complaint. CSSIW will also include within the annual inspection report a summary of any matters it has been involved in together with any action taken by CSSIW. Should you have concerns about anything arising from the inspector`s findings, you may discuss these with CSSIW or with the registered person. Care and Social Services Inspectorate Wales is required to make reports on regulated services available to the public. The reports are public documents and will be available on the CSSIW web site: www.cssiw.org.uk Page 3
Overall view of the domiciliary care agency Age Concern Gwent Domiciliary Care Agency is registered with the Care and Social Service Inspectorate Wales (CSSIW), to provide more than 200 hours of personal care per week. The main agency office is located in Newport City Centre. There are also two sub offices which are located at St Woolos Hospital. The agency provides three distinct services: Prevention of Admission to Hospital (PATH) and Rapid Response Respite Care Hospital Discharge Service (HDS) The PATH and the Rapid Response services are based at St Woolos Hospital, as part of the intermediate care team. As the title of the service suggests, the service provided by the agency aims to prevent individuals from being admitted to hospital. The inspector was informed that referrals to the service can be made seven days per week between the hours of 8am and 8pm. It is planned that service users are seen within two hours of the referral being received. The inspector was informed that both the PATH and Rapid Response services were transferring to the Gwent Frailty Programme, although Age Concern would maintain operational accountability. The Respite Care Service: provides care and support to service users in their own home. The service is flexible to meet the needs of carers and their dependent relatives. The Respite Care Service was the main focus of this inspection. The Hospital Discharge Service: is available to individuals in the Newport area, who have been in hospital and are in need of personal care and support to facilitate an early discharge from hospital. The information contained in this report was obtained from a review of the Self Assessment of Service (SAS) documentation and Annual Data Collection (ADC), which had been provided by the registered manager prior to an announced inspection visit to the main agency office. The inspector visited two recipients of the respite care service, an additional three service user questionnaires were sent as well as five staff questionnaire. Comments received from the questionnaires and the discussions held with the service users are included within the main body of this report. The inspector found the agency to be well managed and provided a valuable service. The agency had continued to develop and were compliant with the Domiciliary Care Agencies (Wales) Regulations 2004 and the associated National Minimum Standards. The inspector would like to thank Mr David Liles, Mrs Eileen Powell, Mrs Anne Jones, and the service users who welcomed her into their homes and shared their experiences of the agency during the inspection process. Page 4
User focused service Inspector`s findings: The agency had a Statement of Purpose and Service User Guide, for the three services provided by the agency. The documents were clear and easy to read, and provided the information necessary for prospective service users to make an informed choice of whether or not to accept the service offered. The inspector observed copies of the Statement of Purpose and Service User Guide in the service users homes visited. The information also contained contact information for the agency. The main focus of the inspection was the Respite Care Service. The inspector in discussion with the service user families found that the service was normally provided on a weekly basis. The amount of hours allocated per individual had been negotiated with the service user family. The relatives of the service users visited stated that the Age Concern Carer provided a service for about four or five hours per week. The relatives confirmed that they had the same carer, except when the individual was on holidays, one relative explained that the relief carer was introduced to the service user and their family prior to them providing care. The inspector reviewed two service user files who were currently using the respite care service, the records contained copies of service delivery plans and what was expected of the carer. There were risk assessments in place. It was evident in the files that the care workers wrote detailed records indicating the level of care and support provided. The inspector was informed that the respite care service was free at point of delivery. The service users families spoken with as part of the inspection were very pleased with the service, and they spoke very highly of the care staff and management team of the agency. The relatives stated that they had been consulted regarding the day of the week, time and the amount of hours they would be allocated. All the responses stated that they would like to receive additional hours. This was also reflected within the responses received to the service user questionnaires The registered manager confirmed that if additional hours were available, they were allocated to those who needed them. Service users confirmed that they had received emergency additional hours, when needed. It was evidenced during the inspection visit that the care staff employed at the agency had received the necessary and appropriate training. It was reported that all care staff completed a comprehensive induction based on the Care Council for Wales Social Care Induction Framework. Requirements made since the last inspection report which have been met: When completed Page 5
Requirements which remain outstanding: (previous outstanding requirements) Original timescale for completion New requirements from this inspection: Timescale for completion Good practice recommendations: None at this time Page 6
Personal care Inspector`s findings: The inspector visited two service users, who were receiving respite care services from the agency. The service user families spoken with were very positive about the service they received. Comments received confirmed that the service provided them with a life line, and that they were able to pursue their own hobbies and interests. The service users relatives stated that the care workers were professional in the way in which they provided care and support, to their loved one. It was reported that the staff went the extra mile to ensure their needs were met, by staying longer when the service user s main carer was unable to get home on time. The inspector reviewed two service user care files. It was observed that each file had been developed on an individual basis and was regularly reviewed. The registered manager confirmed that care and support provided by the respite care support staff, did not replace the care provided by other domiciliary care agencies, and that Age Concern worked with other agencies to provide care packages. The inspector within the service user files noted that the service user had received their care and support from the same carer, with a few exceptions, when the regular carer was away. The relatives confirmed that this continuity had enabled them to feel confident in leaving their loved one. It was observed within the records and in conversations with the relatives that the care staff, provide personal care, drink and meal preparation medication prompting as well as providing a different person to talk to. Comments received from the written service user questionnaire commended the service as excellent. Requirements made since the last inspection report which have been met: When completed Requirements which remain outstanding from this inspection cycle: (previous outstanding requirements) Original timescale for completion New requirements from this inspection: Timescale for completion Good practice recommendations: None at this time Page 7
Protection Inspector`s findings: The agency had a range of policies and procedures in place to assist with the protection of service users and staff. All staff employed by the agency were given a full induction which was in line with the Care Council for Wales Social Care Induction Framework. Staff were given a staff handbook, which contained copies of the policies and procedures, staff were made aware of the importance of confidentiality and the protection of vulnerable adults. The inspector noted that risk assessments were completed with regard to the service users and their environment, care staff were introduced to the service user and their family by the team leader prior to them commencing duty within their home. This was confirmed within responses received to the service user questionnaire. The inspector was informed that the agency had a policy and procedure in place for the management of service user monies. It was confirmed that shopping duties did not normally fall within the remit of the respite care workers. The agency had an appropriate managerial on call system in place. Evidence of this was seen during the inspection visit. The inspector noted that the agency had a valid employer liability insurance certificate in place. The registered manager confirmed that all carers had access to disposable gloves, aprons, and anti bacterial hand gel. The registered manager confirmed that all care workers wore a uniform and were required to carry an identity card. The inspector was informed that lone working arrangements were covered in the staff handbook. All staff were required to contact the on call manager to confirm they had completed their shift and there were no issues. This was confirmed in the responses received to the staff questionnaire. The inspector was informed that all accidents and incidents were reported, records of which, were stored appropriately and, within the service user/staff files. The inspector noted within the two staff files observed that staff had been trained in the All Wales Manual Handling Passport and that on going refresher training was available. All other mandatory training was accessed by the staff employed by the agency. Requirements made since the last inspection report which have been met: When completed Requirements which remain outstanding: (previous outstanding requirements) Original timescale for completion Page 8
New requirements from this inspection: Timescale for completion Good practice recommendations: None at this time Page 9
Managers & staff Inspector`s findings: The inspector was informed that since the last inspection the Responsible Individual (RI) had returned to his substantive post, the acting (RI) had returned to her post as registered manager. It was confirmed that further restructuring of the management team was on going, due to the strategic operation of the PATH and rapid response service moving into the Gwent Frailty Programme. The agency had a comprehensive recruitment policy in place, and its own Human Resource Department. A random sample of two staff files were examined during the inspection visit. It was observed that the files contained all the necessary pre-employment documents and information. It was reported that no staff commence duty until an enhanced Criminal Records Bureau (CRB) disclosure is received. It was reported that CRB certificates were being sought for staff every three years. The registered manager confirmed that staff received an annual appraisal and these were present within the staff files observed. It was confirmed that staff also receive regular supervision. These records were not seen on this occasion as they were stored in the office at St Woolos Hospital, but could have been made available on the inspector s request. The inspector viewed the policy and procedure file for the agency, it was noted that all the policies and procedures were reviewed regularly and there was a system in place to record this. Requirements made since the last inspection report which have been met: When completed Requirements which remain outstanding: (previous outstanding requirements) Original timescale for completion New requirements from this inspection: Timescale for completion Good practice recommendations: None at this time Page 10
Organisation and running of the business Inspector`s findings: Age Concern Gwent Domiciliary Care Agency is registered with the Care and Social Service Inspectorate Wales (CSSIW), to provide more than 200 hours of personal care per week. The main agency office is located in Newport City Centre, There are also two sub offices which are located at St Woolos Hospital. The agency provides three distinct services: Prevention of Admission to Hospital (PATH) and Rapid Response Respite Care Hospital Discharge Service (HDS) The agency premises were suitable for the stated purpose. The main offices were in Newport City Centre, and sub operational offices at St Woolos Hospital. The main office in Newport also had a large meeting room, and smaller office accommodation. The main reception for the Age Concern Charity was located on the ground floor. The inspector was informed that the agency remained financially viable. The agency had produced a quality assurance report following responses to questionnaires and consultations with service users, their families, and staff. Service user families spoken with as part of the inspection rated the service received from the agency as excellent. The inspector was informed that the agency has a comprehensive complaints procedure in place. One reply to the service user questionnaire stated they did know of the complaints procedure, but would know who to contact if they were unhappy with the service. The registered manager confirmed that the agency had received two complaints since the last inspection, it was reported that one complaint had been satisfactorily investigated and closed the second complaint was on going. It was reported that there had been no Protection of Vulnerable Alerts (POVA) since the last inspection. The inspector noted that all records were stored securely within the agency office, in line with the Data Protection Act 1998. Requirements made since the last inspection report which have been met: When completed Requirements which remain outstanding: (previous outstanding requirements) Original timescale for completion Page 11
New requirements from this inspection: Timescale for completion Good practice recommendations: None at this time. Page 12