Wisdom Healthcare Limited was rated Good overall following an inspection on 23–24 April 2015, with strong performance across safe, effective, caring, and responsive domains. The Well-Led domain was rated Requires Improvement primarily due to the provider's failure to return the Provider Information Return and minor gaps in medicines auditing.
Concerns (4)
moderate
Governance
: “They did not return a PIR and the provider told us this had possibly been due to an email issue at the service. This meant that the provider's systems were not suitable and there was a risk that information...may not reach them”
minorMedication management: “We found some minor issues which had not been identified by medicines audits and spoke with the Team Leader about this.”
minorRecord keeping: “we found that one person's work history was missing from their application form, so it could not be established whether references had been provided by their last employer.”
minorCare planning: “we found that one person's records did not contain guidance on how staff should keep the person and themselves safe. This person sometimes presented behaviour which may challenge staff.”
Strengths
· People and their representatives were consistently positive about the caring and compassionate nature of staff.
· Staff demonstrated strong knowledge of safeguarding procedures and could identify external agencies to report abuse to.
· People received visits at agreed times from the correct number of staff who stayed for the full duration, confirmed by electronic timekeeping records.
· Care records were personalised and regularly reviewed; people felt involved in their care planning process.
· Staff received induction training, shadowing periods, probationary assessments, regular supervision meetings, and updated training.
Wisdom Healthcare Limited, a domiciliary care agency serving 22 people in Wolverhampton, received an overall Good rating at its September 2019 inspection, maintaining the same rating as its previous inspection in May 2017. All five key questions were rated Good, with no regulatory breaches identified and consistent positive feedback from people, relatives and staff.
Strengths
· People felt safe and staff were reliable, consistently arriving on time for visits
· Staff were knowledgeable about safeguarding and confident in reporting concerns
· Safe recruitment processes including DBS checks were in place
· Medicines administered as prescribed with MAR records and competency observations
· Staff worked effectively with healthcare professionals including district nurses and GPs
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Preventing and controlling infectionGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Learning lessons when things go wrongGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experience
Wisdom Healthcare Limited received a Good rating across all five key questions at this April 2017 inspection, with 18 people receiving safe, personalised homecare from well-trained and caring staff led by an approachable branch manager. Minor shortfalls were identified in the consistency of care plan documentation and waterlow score recording, and the branch manager acknowledged ongoing challenges with staff recruitment and maintaining regular supervision.
Concerns (4)
minorRecord keeping: “the documentation they were using to monthly review people's waterlow score showed the regular monthly reviews had not consistently been recorded.”
minorCare planning: “one person's care plans did not provide detailed guidance for staff on how to support the person with their particular needs.”
minorSupervision / appraisal: “at times it was difficult to maintain regular staff meetings and one to one meetings with staff because they had to cover some care calls.”
minorGovernance: “At our previous inspection visit we found the provider had not returned the Provider Information Request which we had asked for.”
Strengths
· People felt safe and trusted staff, with staff demonstrating good knowledge of safeguarding and risk management.
· Staff received relevant training, induction and support, and demonstrated strong skills and knowledge in meeting people's needs.
· Staff had formed positive, caring relationships with people, treating them with dignity, respect and promoting independence.
· Care was personalised and responsive to individual needs and preferences, with flexible service delivery.
· Branch manager had an open, approachable leadership style, provided care herself and was well-regarded by people, relatives and staff.
Good
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood