Archived: Carewatch (Hampshire South)

Carewatch (Hampshire South) provides care to people living in their own homes across various locations in and around the Hampshire area. The number of hours provided to people had significantly reduced since our last inspection. The provider’s documentation showed the Chandlers Ford office was commissioned to provide 2,977 care hours per week compared to 4,260 per week when we inspected in September 2015.

At our announced inspection on 14, 15 and 16 September 2015, the provider was in breach of nine regulations relating to; person-centred care, dignity and respect, need for consent, safe care and treatment, safeguarding service users from abuse, meeting people’s nutritional and hydration needs, receiving and acting on complaints, good governance and staffing.

We took action and issued warning notices against the provider in relation to staffing and good governance. We told the provider they must meet the requirements of these notices by 14 March 2016. We rated the service ‘Inadequate’ and it was therefore placed in 'Special measures'. The provider sent us an action plan to tell us how they would meet the requirements of the warning notices and how they would meet the other regulations.

We undertook an announced comprehensive inspection on 22, 23 and 24 March 2016 to check they had followed their plan and met the legal requirements in relation to the warning notices we issued and the other breaches. At this inspection we found significant improvements had been made. The provider had met the warning notices, however improvements were still needed to be made with some of the other regulations requiring improvement. The rating for Carewatch (Hamsphire South) has been changed from ‘Inadequate’ in every domain to ‘Requires Improvement’ in every domain and therefore the service will be taken out of special measures, though improvements will need to be sustained.

Significant progress had been made in respect of the number of suitably skilled, qualified and experienced staff deployed. However the provider still required improvements to ensure all care visits were delivered.

Significant progress had been made in respect of staff training and induction. However the provider still required improvement to ensure all staff were appropriately trained to meet people’s individual needs.

Significant progress had been made in relation to staff supervision and appraisal. However the provider still required improvement to ensure all staff are given the opportunity to discuss their learning objectives and to meet formally with their manager.

Progress had been made in how the provider checked staff were of suitable character to care for vulnerable people. Improvements were still required to ensure the provider’s recruitment processes were robust.

The provider was aware of who required assistance with their medicines and medication administration records were now in place. However the provider required improvement to ensure reasons for the administration of some medicines such as paracetamol, were always recorded.

People told us they were treated with dignity and respect when they received care. However improvements were required to ensure people’s queries about their care were responded to in a timely manner.

Improvements had been made in how staff applied the Mental Capacity Act 2005. Although progress was slow in this area it was clear the provider had working plans in place to ensure people’s choices were respected and that decisions were made in people’s best interest.

Improvements had been made in how people were supported to reduce the possibility of becoming malnourished or dehydrated. Records in people’s homes provided staff with guidance on how to encourage people to eat and drink.

People’s care records were personalised and reflected their actual needs and preferences. Care plans had been recently reviewed and updated with the involvement of the person receiving care and their family member where possible.

The culture within the service had dramatically improved and staff felt supported by their manager. People, relatives and healthcare professionals all told us the leadership was honest and willing to learn from mistakes made in the past.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

If you want to see the evidence supporting our summary please read the full report.

During our inspection we looked at the care records of 12 people that use the service. We also spoke with five relatives,14 people, two care coordinators, five care workers, two supervisors, the registered manager, the operations director, one internal trainer, a care manager from the local authority and one administrator.

Is the service safe?

The provider had effective systems in place in order to safeguard people from possible abuse. Records showed that care workers and care coordinators received training in safeguarding of vulnerable adults. Care workers were knowledgeable about the safeguarding policy and the whistleblowing procedure, and told us they were confident the registered manager would act appropriately regarding any concerns raised about abuse. Records demonstrated the provider communicated effectively with the local authority, and that care plans and risk assessments were updated to reflect any changes in support delivery.

Is the service effective?

Care workers we spoke with had good understanding of people's needs and told us they felt the care plans and risk assessments that were in place were effective. We found evidence to demonstrate the provider had an effective complaints system in place and concerns had been fully investigated. We also found the provider had an effective system in place to check and reassess the suitability of care workers to work with vulnerable people.

Is the service caring?

People using the service and their relatives were complimentary about the attitude of care workers. One relative said: "The care workers are excellent". A person we spoke with said: "they are absolutely brilliant, so caring and helpful". People's preferences and interests were recorded and care and support was provided in accordance with people's wishes. We found evidence that some people using the service and their relatives completed a satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

People's needs had been assessed before they received care.This included involving them in regular care reviews and keeping them or their relatives informed of changes, if appropriate. We saw that people's health needs were monitored and if necessary the support of health care professionals obtained.This helped to ensure that the delivery of care was responsive to people's needs and based on up to date information and guidance. The records showed that any concerns were followed up and relevant action was taken.

Is the service well led?

There were clear lines of accountability within the service. We saw evidence that regular audits of the quality and safety of the service were carried out. For example, there were audits of the care plans and care workers training records. In addition to these, the operations director for the organisation also carried out regular checks that procedures were followed. We saw regular meetings took place between the operations director and the registered manager at which actions to carry out improvement as needed through audits and surveys were followed up.