Care and Social Services Inspectorate Wales

Age Concern Morgannwg were the subject of an unannounced focused inspection between 11th March & 28th March and the report from that inspection has now been published by the Care & Social Services Inspectorate Wales. We are particularly delighted with the outcome of this report given that we are currently in the process of developing our domiciliary care services.

Summary

About the service

Age Concern Morgannwg, registered since August 2009 to provide domiciliary care, provides a range of services in a home environment,particularly of a short term nature. These have included, since the last inspection, providing short term care for those released from hospital.

What type of inspection was carried out?

This unannounced focused inspection considered the quality of life theme and the experience of people using the service. Information for this report was gathered from the self assessment of service documentation, sight of three care files, sight of two staff files, a sample of other documentation, discussion with service user's families, the quality assurance report and a discussion with the registered manager.

What does the service do well?

A thorough assessment of needs is undertaken prior to the service user's discharge from hospital which includes a hospital and home visit. Service user's families and professionals praise the service for being prompt, professional and caring.

What has improved since the last inspection?

Support plans are person centred and enable service users and families to be involved in care planning.

What needs to be done to improve the service?

The service is in ‘transition’ currently, and continues to strive to maintain high quality service provision. They have recently begun providing domiciliary care services for a local authority and there is a need to ensure staff are able to deliver the service required. Staff files need to meet recruitment procedures so should include DBS (CRB) information and any gaps in employment history.

QUALITY OF LIFE

Overall people have a good quality of life, where a thorough assessment of needs is
undertaken and where the service received is prompt, professional and caring.
People are able to exercise their rights, have a voice and are encouraged to speak up,
are listened to and are treated with dignity and respect.

Families, Health and Social care Managers, service users and families are able to be
involved. Needs and preferences are known and reflected in the care given. Care files
were viewed and evidenced person centred planning where specific requests from
families and service users,for certain elements of the care were included. Service user's
families were very pleased with the service provided. One commented: ‘… they do what
my husband needs’. She added that when someone came to find out about the service
required, they spent a long time assessing the needs. The co-ordinator of the outreach
team ensures that the service user is seen within the context of the environment and
asks for input from the service users and family. A stake holder commented that staff
were:‘very courteous and professional and understanding of my concerns for the
service user’.

People using the service experience well-being, feel their diverse needs are catered for
and the service is prompt and diligent in delivery and people are able to be involved in
the review process.

The agency provide a personalised service based on the needs identified in the
assessment process. Furthermore, support plan review procedures are in place to
ensure the service delivered meets ongoing needs. Care files examined indicated that
reviews are conducted and continue to involve the service user and family in the
process. The support plans indicate that they take account of any needs particular to the
individual. A service user's family spoken with said that the needs of her relative were
taken into account. Dependent upon the nature of the service provided, service users
are encouraged to be as independent as possible. We (CSSIW) were informed their staff
support service users and families to access community activities or day centres, helping
them to reduce social isolation.

The physical well-being of service users is being maintained and they have access to
health professionals if required and appropriate.

Particularly for the hospital discharge scheme, service users are supported and
encouraged to look after themselves and exercise control over their own care. Care files
indicated that service users have contact with appropriate health professionals and
service users relative felt that they were helped as much as they required. In all three
care files viewed, the service didn’t include administration of medication as this was not
applicable. Training for staff should be appropriate to the needs of service users and the
agency should monitor and audit staff training dependent upon these needs. Evidence
indicated that the agency liaise with hospital medical staff and agencies such as ‘meals
on wheels’,in order to ensure a ‘safe’ discharge from hospital and that appropriate
facilities are in place on the service users discharge.

People are supported because their needs are anticipated;they experience warmth and
feel recognised by others. Person centred planning and a thorough assessment of needs try to ensure that,within their home environment, service users and their relatives feel supported and recognised by others. Domiciliary services, we were informed, include support with shopping,
access to advocates, liaising with health and social care professionals and helping people be able to talk to support staff. Comments from professionals include: ‘I have been very impressed with the service given to my client’ ‘efficient staff and very prompt response’
In a quality assurance questionnaire to professionals (referrers) 9 out of 9 responded
positively when asked if they were happy with the service delivery and respectful of the
needs of the service users.

In addition to providing direct care and emotional support to all service users, the agency
offer,to every referred service user,a benefit check to maximise their income.

The wife of a service user commented that ‘the service is excellent, they cater for my husbands
needs, the carers are very, very helpful and supportive and I have no complaints at all’.