Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Aylecare Domiciliary Services 11 Alexandra Road Gorseinon Swansea SA4 4NW Type of Inspection Baseline Date(s) of inspection 6 May 2014 Date of publication 12 July 2014 Welsh Government Crown copyright 2014. You may use and re-use the information featured in this publication (not including logos) free of charge in any format or medium, under the terms of the Open Government License. You can view the Open Government License, on the National Archives website or you can write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk You must reproduce our material accurately and not use it in a misleading context.
Summary About the service Aylecare is a large domiciliary care agency that provides a service to adults in the South West Wales region. The agency office is based in the small town of Gorseinon in the City of Swansea with easy access for people and staff. The registered provider Glenda Humphreys is also the registered manager. The registered manager is well supported with a general manager, care manager, 5 care coordinators, 1 senior care coordinator and office staff. What type of inspection was carried out? This was a scheduled unannounced baseline inspection looking at the themes of Quality of Life, Quality of Staffing and Quality of Leadership and Management. This inspection was carried out by one inspector. The methods used in this inspection included: Two visits to the agency office Home visits to four people who use the service and spoken with a further two people by telephone which included one relative. Examination of six staff records Discussion with and information provided by office staff and care staff Discussion with and information provided by the care manager, general manager and care coordinators Attending a staff meeting What does the service do well? No significant areas of good practice were identified at this inspection which was over and above that which is determined by the National Minimum Standards for Domiciliary Care Agencies in Wales 2004. What has improved since the last inspection? A significant number of new care staff has been recruited since the last inspection which has resulted in improved continuity for people who receive a service. 3
What needs to be done to improve the service? Whilst we found no non-compliance issues to report we identified some areas which require attention and will heighten the quality of the service provided: It is recommended that staff supervision and appraisal must take place within the required timescale and recorded in individual staff files. Further work is required to ensure that at least 50% of care staff holds a relevant qualification as listed in the Care Council for Wales Qualification Framework, and in accordance with National Minimum Standard. It is recommended that Individual staff training files should to be put in place as there was insufficient documentary evidence that the planning and delivery of training for staff was up to date. It is recommended that online employment applications submitted should be signed by the applicant at the earliest opportunity. It is recommended that people and / or their relatives sign their care delivery plans to evidence they have full involvement in the process. 4
Quality of life People using Aylecare Domiciliary Services service can be assured that they will be treated as individuals and their privacy and dignity will be respected. The people we spoke with told us (CSSIW) that they were very satisfied with the care they received and said that carers were friendly and courteous and always treated them with respect. They said that the continuity of carers has improved and they mostly visit at the times agreed. People who receive a service are listened to and able to make choices about how they receive personal care in their own homes. This is because the registered manager ensures that the agency visits people prior to the commencement of a service, and seeks their views and wishes regarding the service they require. Peoples records seen at the agency office and in their homes had an initial assessment and care plan in place which detailed how the persons needs were to be met. Feedback from people we visited confirmed that they had been provided with the opportunity to contribute to the care planning process. However, we did not see any signatures of the people who had contributed to the assessment and care planning process. The registered manager should ensure people and or their relatives sign their care plans whenever possible to evidence they have full involvement in the process. The agency promotes the health and safety of the people who use the service. This is because they assess the risks to people and ensure that care staff are provided with personal protective clothing, such as disposable gloves and aprons to guard against cross infection. We noted supplies of personal protective equipment at the agency premises. People who receive a service are assisted to remain healthy because their needs are anticipated and they are enabled to have access to specialist and medical support. The care manager confirmed that good links have been established with medical and specialist support services, for example, general practitioners, community nurses and social workers. All contact with such services is clearly documented. Overall we found that people value the relationships they had made with the care staff supporting them and they had confidence that staff could meet their needs. We felt that, despite a high staff turnover earlier in the year, people were now able to develop a feeling of attachment and safety. 5
Quality of staffing People using the service could be mostly confident that they were being cared for by staff that was robustly recruited and inducted into the agency. We examined six (6) newly recruited staff files which all had evidence that a Disclosure and Baring Service (DBS) check had taken place prior to the commencement of employment. In addition staff files showed evidence of fully completed application forms, the required references, identification and a recent photograph. However, we did note that online applications had not been signed by the applicant. The agency should ensure that all applications are signed by the applicant at the earliest opportunity. A two day induction followed confirmation of employment, thereafter all new carers accompanied a more experienced carer for two weeks or until they felt confident and competent in their role. This was confirmed by people we visited who receive a service. People could not be confident that education and training was adequately recorded. Individual staff training files was not available, but we were shown evidence in attendance logs that staff had attended relevant training. This did not provide sufficient documentary evidence that the planning and delivery of training for staff was up to date. We explored this with the care manager who assured us that all staff had received the mandatory training required and agreed to put in place individual training records for every member of staff to evidence subject, date and when the update is required. People could not be confident that care staff are supervised and their performance monitored regularly in line with The National Minimum Standards for Domiciliary Care Agencies in Wales. The staff files we examined evidenced that one to one supervision did not take place within the required timescale. This was discussed with the care manager who informed us that the agency is in the process of developing area teams. The supervision of care staff will then to be addressed by allocating the task to the five area care coordinators. We were assured that this process is to begin with immediate effect. In addition further work is required to ensure that 50% of care staff holds a relevant qualification as listed in the Care Council for Wales Qualification Framework, and in accordance with National Minimum Standards. We found that staff was well motivated and enthusiastic about their role. We attended a staff meeting and saw that staff was encouraged to identify and report back those people they felt needed a review of the service. In addition they were kept up to date with recent reviews and new care plans and were fully involved in discussions. We saw that care staff was able to raise issues confidently during the meeting which were addressed fairly both during the session and afterwards on an individual basis. Overall we found that people who receive a service are generally happy with the care they receive. No one spoken with raised any concerns or made any negative remarks regarding the care staff. We found that the staff had been properly and robustly recruited and were working with appropriate uniform and identification. 6
Quality of leadership and management The registered provider / manager of Aylecare Domiciliary Services continues to be Glenda Humphreys who is appropriately qualified for her role. She was unavailable during this inspection. CSSIW were assisted by the care manager and general manager. There was a clear management structure in place. The registered manager had overall responsibility and accountability but delegated much of the management responsibilities to her management team which included the general manager, care manager and care coordinators. People who use Aylecare Domiciliary Services can be confident that they are safe because the service is adequately run. Administration systems are generally well organised and records are being maintained although there are areas in need of improvement as mentioned in other areas of the report. People we spoke with confirmed that they had access to all the relevant information including how to contact the agency. We seen that the people we visited had a home file in place that contained a statement of purpose, care plans and daily diary records of visits. People said they knew who to speak with if they had any concerns or complaints. People can be confident that the registered manager and her management team continue to improve the service by regularly reviewing all policies and procedures and regular undertaking quality monitoring reviews. The quality review was being undertaken at the time of inspection and we seen that the views of people using the service and their families was taken into account. Staff spoken with during the inspection stated that they were supported well and encouraged to improve their skills through training. They said that they could contact the manager whenever they thought it was necessary. 7
Quality of environment This is a domiciliary care agency and other than the office premises; the quality of the environment is not relevant in this instance. However some observation was made during the course of the inspection. The office premises are maintained in good order with due regard to the security of personal information. All necessary equipment is available for the day to day running of the agency office. The office allows easy access to the general public and staff with a reception area and meeting rooms. 8
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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. 10