Archived: Carewatch (Whitebeck Court)

Updated 17 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 19 and 20 October 2016 and was unannounced. The inspection was completed by one adult social care inspector.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information in the PIR, along with other information that we held about the service including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.

We contacted the local authority commissioning and safeguarding teams as well as the local Healthwatch board.

During the inspection we observed interactions between staff and people who used the service. We spoke with three people, one relative, the registered manager, the deputy manager and five care staff. We looked at records relating to the service, including three care records, three staff recruitment files, daily record notes, medication administration records (MAR), audits completed to monitor the quality of the service, accidents and incidents and policies and procedures. Following our inspection we spoke with a local authority social worker.

The previous inspection took place in November 2013 and no concerns were identified.

Updated 17 December 2016

This was an unannounced inspection carried out on the 19 and 20 October 2016.

Carewatch Whitebeck Court is a domiciliary service based in one block of flats – Whitebeck Court, which contains 91 individual flats. The block is owned and managed by a housing association and is specifically designed for people who are over 60 and have been identified as requiring support now or potentially in the future. Carewatch currently provide daily support for 23 people. They also respond to emergency pendant calls from any of the 91 flats. The service did not support any other people who did not live within the Whitebeck Court flats.

The service had a registered manager who had been in post since December 2015. 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.

The service also had a deputy manager in post. They had recently been promoted and had been a team leader at Whitebeck Court for five years. There were at least two staff members on duty at all times, including throughout the night. Additional staff were also on duty during the busier morning and tea time periods. Each shift had a team leader on duty. An on call system was also in place that meant a manager was available for staff to contact at any time.

All the people we spoke with, and their relatives, said they felt safe supported by staff from Carewatch Whitebeck Court. Staff had received training in safeguarding vulnerable adults and knew the correct action to take if they suspected any abuse had occurred. Staff said the registered manager and deputy manager would listen to any concerns raised.

Where Carewatch had responsibility to administer people’s medicines they were administered safely. New Medication Administration Records (MAR) were had been introduced which included a clear body map to show where any creams needed to be applied. However there was some confusion where staff should sign to state they had applied the prescriber creams; on the MAR or on the body map chart. The registered manager told us they would provide clear direction for staff so the recording of creams was consistent.

The service was working within the principles of the Mental Capacity Act (2005) (MCA). The local authority social workers assessed people’s needs and gained consent or completed best interest decisions for the support required before Carewatch were engaged to provide the support. People and their families, where appropriate, were involved in agreeing the support to be provided by the service. People who had capacity signed their care plans. We saw new care plans were being introduced which included a clearer, more detailed section for assessing people’s capacity to consent to their care and support.

Care plans and risk assessments were in place for each person who used the service. These gave guidance to staff on the support people required and how to mitigate any risks identified. New care plans and safe working risk assessment were being introduced by the service which prompted for more detailed information to be included. Care plans were reviewed annually.

A robust system of recruiting and training staff was in place. Staff completed four days of mandatory training courses and undertook three shifts shadowing experienced team leaders before being placed on the rota. Training was refreshed on an annual basis.

Spot checks were completed every three months where the registered manager or deputy manager observed staff during a support visit. Formal supervisions were held every six months. These were slightly behind schedule, with the new deputy manager completing additional spot checks to get up to date. Staff told us they felt well supported by the registered manager and deputy manager and they were always available by telephone if staff needed guidance or had a concern. This meant the staff had the skills, knowledge and support to provide effective care.

People who used the service and their relatives were complimentary about the staff at Carewatch Whitebeck Court. Staff had a clear understanding of people’s needs. Staff could explain how they delivered person centred care and respected people’s dignity and privacy. Staff supported people with their nutritional and health needs where applicable.

A system of monthly quality audits was in place for daily logs, medicines, people’s finances. Any issues and actions taken were recorded. However the audits had not been completed since June 2016. The registered manager was aware of this and said it had been due to service having to recruit a new deputy manager. They were now in place and so the audits would restart. We will check this at our next inspection.

Carewatch also had a central quality team who completed annual audits of the service. We saw the audit compliance had improved significantly between an audit in April 2016 and a return visit in June 2016.

We had been told by the local authority commissioner and a social worker that the registered manager had not always been available when they visited or telephoned. We discussed this with the registered manager who acknowledged this had been an issue when there had not been a deputy manager in post. The social worker told us this had improved and they were now able to contact the registered manager when they needed to.

There was a system in place to record, investigate and learn from complaints. Additional monitoring systems had been introduced where one person who had made a series of complaints.

Incidents and accidents were recorded and reviewed to reduce the likelihood of the incident reoccurring.

The service was working with the local authority and housing association to support people moving to a re-ablement flat in the block. This was used for people who needed support for a short period of time following discharge from hospital. The service was flexible to meet the different needs of the people using the re-ablement flat.