Wales England Care
The Coach House, Phillip Street, Risca, NP11 6DF
Tel: 01633 264121
Email:Hayley.buxton@walesenglandcare.co.uk
Contract Monitoring Report
- Name/Address of Provider: Wales England Care, Coach House Workshop, Phillip Street, Risca, NP11 6DF
- Date/Time of Focussed Monitoring Visit: Thursday 15 February, 2024, 10.00 a.m. – 2.30 p.m.
- Visiting Officer(s): Andrea Crahart, Contract Monitoring Officer, Caerphilly CBC
- Present: Hayley Buxton, Registered Manager
Background
The range of care and support tasks undertaken by Wales England Care include personal care (e.g. assistance in bathing, washing, dressing, taking medication and intimate personal care needs), nutritional care (e.g. assistance with eating and drinking, food and drink preparation, and food and drink intake monitoring), mobility care (e.g. assistance with getting in and out of bed, general movement). These are to be provided in a personalised manner, ensuring that individuals have interaction, companionship and stimulation from the care and support provided.
Wales England Care Ltd. Domiciliary Care service is part of the ‘Support at Home’ framework which was awarded due to being part of a tender exercise within Caerphilly and Blaenau Gwent Local Authorities some years ago.
At around the time of the visit to Wales England Care they were providing 68 hours to 6 people in the Caerphilly area. The provider is keen to extend into various parts of the borough and is actively recruiting health care professionals (carers) in order to do this.
The previous monitoring visit was completed in January 2023 and at this point there were 3 corrective actions identified, with no developmental actions to progress. It was evident from the current visit that these remained ongoing.
Over the previous year no official complaints were received within Caerphilly Social Services, however a few concerns had been communicated through to the Commissioning Team which needed to be addressed, and some included concerns that were route to the Safeguarding team.
The Care Inspectorate Wales (CIW) has undertaken visits to Wales England Care in 2023 who identified a number of areas that required attention. However since this time the provider has made significant improvements and therefore the Priority Action Notices (PAN’s) that were issued have been closed, but there is one area for improvement outstanding.
Dependent on the findings within the report, the provider will be given corrective and developmental actions to complete. Corrective actions are those which must be completed (as governed by legislation etc.), and developmental actions are good practice recommendations.
Previous Recommendations
Corrective
Policy/Procedure relating to induction/training/development of staff to be updated to reflect the current process to register with Social Care Wales. Timescale: Within 3 months. Not met.
Travel time to be built into the runs to ensure there is sufficient time for health care professionals to arrive at the call in a timely way and to meet the requirements of the Regulation and Inspection of Social Care (Wales) Act 2016. Timescale: Immediately and ongoing. Remains ongoing.
Training to include food hygiene, dementia awareness, sensory impairments, catheter/stoma care and stroke awareness. In addition to any other areas the provider identifies that are needed to ensure staff can fully support people. Timescale: Ongoing. Partly met.
Developmental
There were no developmental actions.
Registered Individual
The Regulation and Inspection of Social Care (Wales) 2016 Act (RISCA) places expectations on the Registered Individual (RI) to have an oversight of the service, and to report on its performance and quality. The RI provided the last 4 quarterly reports that had been written, which examined the performance of the agency, where feedback had been gathered directly from service users, health care professionals and other pertinent information gathered (e.g. staffing levels/turnover, qualifications achieved, any complaints, safeguarding issues etc.). The most recent 6 monthly Quality Assurance review reflected the findings of the quarterly reports and included some areas to improve upon also.
The provider’s policies and procedures were viewed as part of the process e.g. safeguarding, medication, disciplinary, training/development of staff etc. The policies had been comprehensively written and had been reviewed in 2023. One of the policies was still noted to need revising to bring up to date with the current ways for health care professionals (care workers) to register as a care worker with Social Care Wales.
The provider’s Service User guide was very comprehensive and was up to date.
The Statement of Purpose relating to the organisation had been reviewed very recently in February 2024. This included reference to the provider promoting ‘The Active Offer – More than Just Words’ Welsh language Act, where staff are encouraged to greet people using Welsh phrases and arrangements can be made for paperwork to be written in both English and Welsh.
Registered Manager
The Registered Manager is registered with Social Care Wales (the workforce regulator).
Care and Service Planning Process
Some service user information was viewed on the system as part of the monitoring process. Information such as Caerphilly County Borough Council (CCBC) Care Plans, manual handling plans etc. were present and Personal Plans (Service Delivery Plans) had been written in relation to these and corresponded. Background information had been captured in relation to the people concerned so that health care professionals would know something about the person prior to visiting them. There was evidence that information had been reviewed regularly also. There were no risk assessments present for any of the service users records seen on this occasion.
Professionals (district nurses, social workers) and family members will need and want to view the service user’s records on occasions and arrangements are in place for them to have access to the Birdie electronic App, with agreement.
Call Monitoring
Wales England Care operate an electronic system named ‘Birdie’ which holds all information relating to service users. This requires the use of mobile phones where Health Care Professionals log in and out of calls electronically with the use of an App on their phone which allows them to see the information they require to carry out the visit. There is the ability to record what tasks have been undertaken during each call and add additional information into the system e.g. how much a person has eaten/drunk, what their mood was like etc. This has the benefit of the information being able to be viewed by the office staff in ‘real time’ and issues/alerts can be forwarded straight to the office. From the records viewed the ‘observations’ that were captured on the visits made were very thorough.
Staff related documentation
Two staff files were viewed via the electronic Birdie system. It was evident that all recruitment information was present e.g. references, application forms, interview records, contracts of employment, Disclosure and Barring Service (DBS) information etc. The interview record included some probing questions (e.g. what would you do if someone did not want to eat/get washed?).
A training matrix was provided during the visit which illustrated that a large range of training was being delivered and the majority of staff were up to date with their training e.g. medication, safeguarding etc. However, training in relation to catheter care, stroke awareness and sensory impairments were lacking. The provider ensures that training that is delivered is done so both face to face and on-line (via ‘Social Care TV’).
Staff are required to receive formal supervision on a quarterly basis to ensure they are supported in their roles. The Contract Monitoring Officer was able to see from a matrix that sessions were planned for in the immediate future and from the staff files viewed it was evident that supervisions had been held at regular intervals. Typically supervision sessions covered topics such as any actions to discuss from the previous session, attendance levels, service user concerns, personal performance, health and welfare, learning and development, company communications and any actions to take forward. Staff have also received appraisals during 2023 and there were many planned for in 2024.
The majority of staff at the current time have registered as carers, which is a requirement with Social Care Wales (workforce regulator).
A large proportion of Health Care Professionals had received a ‘spot check’ in the first quarter of the year, which is where staff are assessed whilst they perform their tasks. The Spot check process involves checking e.g. arrival times, whether the Personal Plan was read prior to visiting, whether correct procedures were followed regarding medication, communication skills, whether they were wearing the correct uniform/ID badge etc. Although ‘shadowing’ sessions had taken place, as confirmed by some Health Care Professionals documentation appeared to be lacking during the visit.
Carer related questions
Carers were asked questions relating to whether they had sufficient time in between calls, with one replying that they did and another stating that this was not always the case. One carer confirmed that Personal Plans provided adequate information to know how to best support a person and the other felt that some additional information would be beneficial. Both carers had undertaken their mandatory training, however some queries arose that the Contract Monitoring Officer planned to query with the office. Carers confirmed they had received an induction and shadowing process to introduce them to the role.
General
The current staffing structure consists of a Chief Financial Officer, Chief Operating Officer, Responsible Individual, Registered Manager, Service Manager, Assistant Service Manager, Co-ordinator, Field Supervisor, an administrator and Health Care Professionals (carers). Wales England Care also provide care/support in the Newport, Torfaen and Cardiff areas.
Some team meetings for 2023 were provided which had been attended by new carers to the service and others. Subjects included e.g. training, food preparation, rotas/keeping to call times, staying the duration of the call, what is classed as an emergency, Birdie electronic system updates etc.
Some areas of good practice were sought and confirmed to be the provider’s compliance dashboard (in terms of the number of spot checks undertaken and supervisions held); how drivers are employed to assist the walking care workers so they can get to and from work safely; carrying out independent service user feedback forms after a spot check has been carried out; using integrated systems for care planning to be completed.
Staff turnover in the first quarter of the year was 28%, with a target to reduce this to 10%, which was achieved by quarter 3, which is currently 3.4%. Staff retention continues to be good which is positive in terms of continuity for service users and beneficial for Wales England Care.
Recommendations
Corrective
Specialist face to face training in relation to Catheter care to be organised. Timescale: Immediately and ongoing. RISCA Regulation 36.
Stroke Awareness and Sensory Impairment Awareness training to be organised. Timescale: Within 3 months and ongoing. RISCA Regulation 36.
Policy relating to Staff Development to be revised with the methods for staff to register with Social Care Wales. Timescale: Immediately (this was an action from the monitoring visit conducted in 2023). RISCA Regulation 38.
Shadowing documentation to be available via the electronic system. Timescale: Within 3 months and ongoing. RISCA Regulation 36.
Conclusion
Wales England Care previously had 2 electronic systems which had been cumbersome to use, but they now have introduced the Birdie electronic system where all information, both service user and staff is stored for easy access.
Documentation relating to both service users and staff appeared to be robust, although feedback from a Health Care Professional suggested that some additional information could be added to Birdie to assist them, however feedback regarding its use was generally very positive.
It was pleasing to see that training and supervision for staff was up to date and that the matrix clearly illustrated what had been achieved and what was planned for. Further development of some additional training is required to ensure staff’s understanding and competency.
Staff turnover continues to be low which is hugely beneficial to enable consistency during calls.
The Contract Monitoring Officer would like to take this opportunity to thank the staff team for their time and hospitality during the visit.
- Author: Andrea Crahart
- Designation: Contract Monitoring Officer
- Date: March 2024