23 January 2015
During a routine inspection
This inspection took place on 23 January 2015 and was unannounced. Carewatch (Westminster, Kensington and Chelsea, Hammersmith and Fulham, Wandsworth, Lambeth) is a domiciliary care
agency providing care to adults living in their own homes within the London boroughs of Westminster, Kensington and Chelsea, Hammersmith and Fulham, Wandsworth and Lambeth. 298 people were using the service at the time of our visit.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People’s views about the service were mostly positive though we heard complaints about staff arriving late or not at all to scheduled visits. Relatives and representatives of people using the service told us they thought the service was at times poorly managed but that staff were doing their best.
The service received referrals via email or telephone from social workers based in and around the local community. An initial assessment process was carried out by senior staff to ensure people’s care needs could be met before a package of care was organised and care staff allocated.
Care plans were developed in consultation with people and their family members. Where people were unable to contribute to the care planning process, staff worked with people’s relatives and representatives and sought the advice of health and social care professionals to assess the care needed.
People’s risk assessments were completed and these covered a range of issues including personal care, falls prevention and guidance around moving and positioning. Staff had guidance about how to support people with known healthcare needs, such as when a person needed support with mobility equipment such as hoists and wheelchairs.
Most staff were familiar with the provider’s safeguarding policies and procedures and able to describe the actions they would take to keep people safe. There were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being. These included contacting people’s GPs, social workers and family members for additional advice and information.
Staff were required to support people to complete shopping tasks and prepare simple meals. Staff were aware of people’s specific dietary needs and preferences and offered people choices at mealtimes. Where people were not able to communicate their likes and/or dislikes, staff sought advice and guidance from family members.
People’s independence was promoted and staff were able to explain how they respected people’s privacy and dignity. Staff understood the importance of gaining consent from people before they undertook personal care tasks.
There were arrangements in place to assess and monitor the quality and effectiveness of the service but staff were not always following the provider’s policies and procedures in regards to the logging and reporting of complaints and safeguarding matters.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to notifications, care and welfare, complaints and quality monitoring. You can see what action we told the provider to take at the back of the full version of this report.