Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Age Concern Gwent 12 Baneswell Road Newport NP20 4BP Type of Inspection Baseline Dates of inspection 30 January 2014 Date of publication 6 March 2014 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 Please contact CSSIW National Office for further information Tel: 0300 062 8800 Email: cssiw@wales.gsi.gov.uk www.cssiw.org.uk
Summary About the service Age Cymru Gwent Domiciliary Care Agency is registered with the Care and Social Services Inspectorate Wales (CSSIW), to provide personal care to people in their own homes. The main agency office is located in Newport City Centre. There are two sub offices which are based in St Woolos Hospital Newport. Age Cymru is a registered charity, The agency currently provides three distinct services: Prevention of Admission to Hospital (PATH) Hospital Discharge Service (HDS)/Rapid Response Respite Care Individuals are referred to the above services according to their needs, people are referred to the services by their GP or social worker, There is a nominated Responsible Individual. There were two registered managers David Liles and Anthony Hussein. Mr Liles is responsible for the registered services and he is registered with the Care Council for Wales. What type of inspection was carried out? We undertook an announced baseline inspection of the service as part of CSSIW s programme of annual scheduled inspections. The information contained in this report was obtained from: An announced visit to the agency office on the 30 January 2014 A review of the self assessment documentation received by CSSIW prior to the inspection visit A review of four people s care records held by the agency Review of four staff files Telephone conversations with four people who have received either PATH or HDS services What does the service do well? The agency provides a bespoke service to individuals within Newport. People we spoke with confirmed that the support that they received for the agency had prevented them from being admitted to hospital, or had facilitated an early discharge. What has improved since the last inspection? There have been no significant improvements identified since the last inspection. What needs to be done to improve the service? There were no issues of non compliance to report. 3
Quality of life People who receive a service from Age Cymru Gwent can feel assured that they will receive a responsive and bespoke service. People we spoke with confirmed that the agency provided them with the care and support they required to either prevent admission to hospital (PATH), facilitate an early hospital discharge (HDS) or provide a respite care sitting service. Individuals who use the service can feel confident that their care will be responsive; we were informed by the registered manager that care packages can be set up in place within four hours of the initial referral, for PATH and HDS. We reviewed the care files of four people who have recently received a service form the agency. Each person had a detailed pre assessment, risk assessments for care provision and a property risk assessment. A detailed care plan had been produced which was agreed by the service user. We noted that the care assistants kept detailed records of the care given. There was also evidence to indicate that care plans were kept under review and altered as necessary. People we spoke with confirmed that they had been able to discuss suitable times of their calls prior to the service commencing. Individuals told us that the care staff were very helpful and they felt that they went over and above what was expected. They told us that the care staff were unhurried and spent time sitting and chatting with them, two of the respondents stated that they had looked forward to the care assistants visits, as they provided them with reassurance and help to restore their confidence. People told us that they had the same team of care assistants who provided them with continuity and who understood their care needs. We were informed that they were able to contact the agency and speak with the co-ordinator at any time to alter the care package. We were informed that the service is free to those individuals referred to them. Both PATH and HDS services are normally time limited up to six weeks. People who received the service told us that they had received the care for as long as they had needed it. The respite care service is a longer term service and provides support to carers to enable them to have a break from their caring duties. 4
Quality of staffing People receiving support from the agency can feel confident that they will be cared for by motivated staff who want to make a positive difference to people s lives. Individuals can feel safe and protected as all staff employed by the agency were recruited through a robust recruitment process. All staff have a Disclosure and Barring System check on the commencement of their employment. We reviewed four staff files during our inspection and noted that staff had received a comprehensive induction, mandatory training and service user specific training where needed. Staff were supported by the registered manager through regular supervision and annual appraisals. People who receive the service normally receive care from the same care assistant. The majority of staff have worked for the agency for a number of years. We were informed that there is a low rate of sickness and turnover of staff. The registered manager informed us that staff are in the main employed on part time contracts, but will work additional hours to meet the needs of the people referred. People we spoke with spoke highly of the care staff, commenting on their friendliness and professional attitude to the work they were undertaking. 5
Quality of leadership and management People receiving services from the agency could feel assured that they were safe because the agency was well run. Administration was organised and all the required records were being maintained. Policies and procedures were being reviewed regularly and updates made. Regular team meetings were held for the dissemination of information. The registered managers are registered with the Care Council for Wales and the Care and Social Services Inspectorate Wales. Each of the three services provided by the agency has a lead co-ordinator who has responsibilities devolved by the registered manager in the assessment of service users and to lead the staff team. The registered managers have overall responsibility for the agency. The Statement of Purpose and Service User Guide were available. Both documents met with the regulations set out in the Domiciliary Care Agency Regulations 2004, and gave current and prospective service users the information they required to make an informed choice about the service. The agency s quality assurance process was sufficiently robust to ensure that people receiving a service from the agency have the right care package to meet their needs. Comprehensive auditing tools were in place to monitor all aspects of the service. All people who received care are asked to complete a questionnaire we noted that responses to the questionnaires were positive. A copy of the agency s quality assurance report indicated a high level of service was provided. People using the service can be confident that any concerns they have will be addressed promptly. People were aware of how to make a complaint. People we spoke with were extremely positive about the service they had received. 6
Quality of environment People who use the services of the agency can be confident that their personal information is kept securely. The agency operates from designated premises that are suitably equipped for the purpose of the day to day operation and management of the service. Care services are provided in people s own homes. 7
How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focussed inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focussed inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under Quality Themes. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet Improving Care and Social Services in Wales. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. 8