Archived: MyLife (Suffolk)

Carewatch (Ipswich) is a domiciliary care agency providing personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive a regulated activity of personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our visit 71 people were receiving personal care from the service.

People’s experience of using this service and what we found

People were positive about the care and support they received. People liked having the same care staff to support them. They said that staff turned up and did not miss visits, were frequently on time and rarely late. People were provided with a roster of staff who would visit them and therefore they could prepare and plan for visits.

People had benefitted from the considerable work done to revise the routes that staff completed. Staff were able to get from one person to another and arrive at their allocated calls on time as people were expecting and needing them at the scheduled time. People had consistent staff so that they were able to form relationships and develop trust.

People said that they trusted staff and felt safe in their care; staff had received the correct training to keep people safe. One person told us, “Yes I feel safe, they are lovely people and we have a bit of a laugh.”

We found considerable improvement in the delivery of service since our last inspection. Managers had responded well to our concerns and had rectified all breaches of regulation. Management and office staff had changed since our last visit. A new manager had been appointed and registered. We had been regularly updated about improvements made.

Medicines were managed safely. One person told us, “They deal with my medication. They have a cupboard. They never forget to give it to me.” Records were completed and were regularly monitored by managers. Individual risk assessments were in place for people, this included infection prevention and control. People told us that staff always wore aprons, gloves and a mask to prevent the spread COVID-19. This was part of the overall risk assessment completed by the agency in relation to COVID-19.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was inadequate in Safe and Well Led. (published 24 April 2020).

The provider completed an action plan after the last focused inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the service had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carewatch (Ipswich) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Carewatch (Ipswich) is a domiciliary care agency providing personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our visit 84 people were receiving personal care from the service.

People’s experience of using this service and what we found

We carried out this inspection in response to concerns received in relation to staffing levels and recruitment procedures. We had been sharing these concerns with the provider and asked for investigations to be completed since 20 January 2020. Some of the investigations that had been carried out identified shortfalls and further concerns about the service’s safety. The service accepted that there were shortfalls and so we decided to give them time to make some improvements before we visited to inspect and assess how those improvements were going. At the time of our inspection visit a new manager had been in the role one and a half weeks.

Despite input from Suffolk County Council and reassurances from the provider about improvements, we found that the service was not operating in a way which ensured people received the care they required in line with their needs and preferences. Whilst the service told us there had been improvements in reducing missed visits and early/late visits, this was not reflected in records we reviewed at the office which were dated up until 29 February 2020.

The majority of people we spoke with told us the service they received did not meet their needs or preferences. People told us of having visits at times which were not in line with their preferences, having to cancel visits because they were going to be excessively early or late and having visits from staff they did not know which made them feel unsafe. People also told us that rota’s they were provided with were sometimes inaccurate as different staff would attend instead of the ones on the rota, without them being informed.

Risks were not assessed or managed appropriately, and systems did not ensure people were always safeguarded from avoidable harm. Medicines were not managed, administered and monitored safely.

We had concerns about the management and oversight of the service, which had previously been rated inadequate before reaching a ‘good’ rating at an inspection on 5 June 2019. Historic concerns were similar to those identified at this inspection, including missed visits, cancelled visits, excessively early/late visits and issues with staffing. The provider had given us assurances on the 22 January 2020 that measures were being taken to ensure adequate staffing arrangements were in place through agencies and that the management team was receiving appropriate support from senior staff. Despite these assurances, the findings of this inspection do not support that improvements were made in a timely way

Recruitment procedures had improved, and these were now safe.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 13 August 2019).

Why we inspected

We received concerns in relation to staffing, missed visits and the management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led sections of this report. The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Carewatch (Ipswich) was bought by CSN Care Group Limited in January 2019, retaining some of its directorship. The service was registered under its new provider name on 17 April 2019. As the service retains some of the directorship from the previous provider, the regulatory history for this service has transferred from the previous registration.

People’s experience of using this service and what we found;

At the last inspection on 17 May 2018 the service was rated ‘Inadequate’ in the Safe and Well-Led domains. Breaches of regulations 9, 12, 14, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified. This inspection was carried out to assess whether enough improvements had been made to the service to ensure people were provided with a service which met their needs. The service still needs to make improvements to fully meet the requirements of the Mental Capacity Act (MCA) and embed its quality assurance system.

At this inspection we found;

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the systems in the service did not fully support this practice because appropriate assessments of people’s capacity had not always been undertaken. This meant it was unclear how the service had determined whether people could consent to care and treatment.

There was a quality assurance system in place which was capable of identifying areas for improvement. The service had a comprehensive action plan in place detailing how they would continue improving the service provided to people. Whilst significant improvements had already been made, more time was required to fully embed this system and some shortfalls had not yet been addressed.

People receiving support from Carewatch (Ipswich) have their needs met by sufficient numbers of suitably trained staff. People told us staff were kind and caring towards them and that they had regular carers visit them who knew them as individuals

People were provided with support, where required, to maintain good nutrition and hydration.

The service had sought people’s preferences in coming to the end of their life and there were end of life care plans in place where this was appropriate.

The service worked well with other organisations to ensure people had joined up care.

People were supported to make and attend appointments with external healthcare professionals where this was part of their agreed support plan.

People and their representatives were involved in the planning of their care and given opportunities to feedback on the service they received. People’s views were acted upon.

This service has been in Special Measures since 20 July 2018. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

See more information in Detailed Findings below.

Rating at last inspection: Inadequate (report published 20 July 2018).

Why we inspected: This was a planned inspection following the service’s registration with the Commission.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Good.