The Care Quality Commission

Archived: NewCare Devon (Exeter)

356 Pinhoe Road, Exeter, Devon, EX4 8AJ (01392) 460046

Provided and run by:
Select Living (Devon) Limited

Important: This service is now registered at a different address - see new profile

All Inspections

18 October 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience, who had experience of using or caring for someone who uses this type of service.

Our first visit to this agency office took place on 15 August 2012. We visited the agency office again on 18 October 2012.

We visited four people in their own home as part of this review and spoke with them and their relatives about their experiences of the support they have received. We spoke on the telephone with 11 people who received a care service. During our visit to the agency office we met and spoke with a senior manager who was managing the agency on a temporary basis while they were in the process of recruiting a new manager. We spoke with six care workers and senior care workers, either during our visit to the agency office or on the telephone.

Most people told us they were generally satisfied with the service they received from the agency. Comments included 'Fantastic ' I couldn't wish for better care!', and 'I can't say good enough about them, some do extra things for me even though they should be going to their next visit'. However, people also told us about some things they were unhappy about, and about some aspects of the service they felt could be improved.

Some people told us some care workers had not always respected their privacy and dignity, but we also heard that there had been some improvements recently, for example 'They were not very good at covering him up, we like the new carer's coming now they are much better in keeping him covered'.

People told us they had a care plan, but it had not been discussed or agreed with them. They did not feel they had been given any choices. Comments included 'No choices given at the outset. They gave me a book with a care plan but have never gone through it with me '. We found that each person had been given a file containing a copy of their care plan.

People told us they were concerned about the reliability of the service and the lack of information about who would be visiting them, or the times of the visits. Comments included 'My main carer is very reliable and comes at 7.30am. The other days I don't know who is coming and they are not very reliable. I have had to ring up to find out if they are coming', and 'I have complained about lateness every weekend. They say they are going to do something about it but nothing happens. I dread the weekends'.

We spoke with a senior manager for Newcare who told us they had recruited more senior care workers in recent weeks. They expected these staff would provide cover during periods of holidays and sickness. They were confident this would result in people receiving visits at the agreed times in future.

Most people said they felt safe, and would contact the agency office if they had any concerns or complaints, although some people said they did not know who they would speak with. At the time of this inspection there was no registered manager in post. A senior manager from Newcare was managing the service on a temporary basis, and we were told they were actively recruiting a new manager for the agency.

We visited the agency again on 18 October 2012 to check on actions taken since our inspection of the agency in August 2012. We found that the agency had taken a number of actions to improve the service since our last visit. The agency was in the process of moving to new premises where they expected to bring about a number of improvements including better facilities for communications. They had drawn up a programme to visit each person who received a service to review their care needs and ensure the care plans accurately reflected people's care needs.

They had carried out visits to approximately one third of people since our last visit to review their care needs with them, and to update and improve their care plans. They expected to complete their remaining visits to people in the following three months. We also saw evidence to show that the level of detail in those care plans that had been reviewed had improved and showed how the person wanted each task to be completed. Complex health and personal care needs were explained in detail.

31 August 2011

During a routine inspection

This review of compliance took place over two days. On 30th August 2011 we visited the offices of Newcare Exeter at 356 Pinhoe Road Exeter to look at records and speak to visiting care workers and the manager. We were also able to be assisted with the inspection by the Director of Operations who was available that day. On 31st August 2011 we visited three people in their homes, meeting with care workers in one home and met with the Director of Operations and the provider to give feedback on our findings.

All of the people we talked to told us they were very happy with the quality of care they have received from the care workers. Comments included 'they are all wonderful' and 'I am treated very nicely and happy with the care provided'. They told us that their regular care workers always treated them with respect and kindness. One person said the care workers were the reason that they had recovered from their illness.

People told us they had telephoned the agency office and that any issues had been addressed such as moving a visit time to a more convenient one for them. Some people said that they did not always see regular care workers but that this had been addressed by the agency and in the main the agency tries to ensure that visits are carried out by regular staff or at least by one care worker who has visited the person before.

We looked at four care plan documents held in the agency office and the following day we visited the people in their homes to find out if the care workers were given sufficient information about the tasks each person wanted them to carry out. We found that the information in the care plans did not always give care workers sufficient information about the tasks, or how the person wanted them to carry out the tasks. However, most people told us that they had a regular group of care workers who knew them well and understood how they wanted to be assisted. The Director of Operations agreed that improvements could be made in this area. Two people told us that their only complaint was when the agency changed their regular care workers. New care workers did not support them in the same way as their regular care workers and people had to spend time telling what to do.

People told us they were satisfied that the agency had taken care to recruit suitable care workers and to ensure that they had the training they needed to meet people's care needs. We looked at the agency's records of recruitment and training and we found that there was a robust recruitment programme. The level of training and support provided to care workers was found to be satisfactory.

We saw that the agency had an efficient computer system that had many effective features that should prevent visits being missed. Each care worker had been supplied with a mobile phone to be used only in conjunction with their work. The mobile phone was also used to log in and out of each home they visited, providing the agency with an effective monitoring record of the start and finish time of each visit. This system alerted care workers if they had missed a visit and the agency told us that this is monitored regularly.

The Director of Operations told us that Newcare were looking into allocating travel time to be included in the staff rotas to ensure that care workers were not rushing between visits and therefore on occasions being late for visits. Newcare are monitoring this.

We also looked at the way the agency had assessed people's needs before the service started. We saw evidence of good assessments of each person's care needs. We were told that Field Manager/Senior Care Assistants carry out the first care visit to ensure they have understood the person's care needs fully. However, they had not fully used the information that they had gathered during the assessment to provide sufficient detail in the care plans. This meant that people could not be confident that care workers who visited them for the first time would know exactly how they wanted to be assisted. The care plans did not explain how the care workers should respect people's preferences and choices or how to carry out the tasks in a way that protected people's dignity so that time had to be spent finding this out on the first visit to provide care.