Archived: Carewatch (Southend)

Carewatch Southend provides personal care and support to adults who live in their own homes in the geographical areas of Rochford, Rayleigh, Castle Point, Basildon and surrounding areas. It is a large service and provides care and support to over 800 people and employs over 250 staff.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manager 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.

Systems were in place to assist people with the management of their medication and help ensure people received their medication as prescribed. However, we did find that people had sometimes received their medication too close together due to times of visits and that one prescription tablet did not always have sufficient time allocated for administration. Action was taken to rectify this straight away.

There were generally sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service, but some people had experienced late or early calls which did not always meet their needs. The provider was very proactive at dealing with these types of concerns and we had confidence that people’s visit times would be addressed as a matter of priority.

Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

Where needed people were supported to eat and drink sufficient amounts to help meet their nutritional needs and staff knew who to speak with if they had any concerns around people’s nutrition. People were supported by staff to maintain good healthcare and were assisted to gain access to a range of healthcare providers, such as their GP, dentists, chiropodists and opticians.

People had agreed to their care and asked how they would like this to be provided. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner. Assessments had been carried out and care plans had where possible been developed around each individual’s needs and preferences.

The registered manager had a good understanding of the Mental Capacity Act and mental capacity assessments had been completed with additional assessments requested from the appropriate government body where people were not able to make significant decisions for themselves.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service had an effective quality assurance system and had regular contact with people who used the service. People felt listened to and that their views and opinions had been sought, as a result improvements had been made through learning from people’s views and opinions.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

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

Is the service safe?

People told us they were satisfied with the way their medicines were handled.

We found people were protected against the risks associated with medicines because the provider had improved arrangements in place to manage medicines.

Below is a summary of what we found. The summary is based on speaking with people who used the service (33), their relatives (13) and from looking at records in the office and within people's homes. On the 17 and 18 March we looked at records at the office, we visited ten people who received a service on 31 March and also sent out 60+ questionnaires to people to gain their views. Twenty five care workers were approached for their views on two occasions. However, only five members of staff contacted us to be interviewed.

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

Is the service safe?

Systems were now in place to make sure that managers and care workers learned from events such as complaints, concerns, whistleblowing and any investigations. This practice helped in assisting the service in reducing the risk to people and helped with identifying improvements required.

There were systems and procedures in place to help care workers identify concerns and respond appropriately to the signs and allegations of abuse. Care workers had been provided with the information they needed to protect people from abuse. They had also completed training on the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), so were aware when to make referrals which helped to keep people safe.

Although improvements had been made with regard to staffing, further action needed to be taken to ensure that service users were protected from the risks of poor staffing levels. The provider had introduced systems to try and minimise missed calls which would assist in keeping people safe.

When we arrived at the service a member of staff asked to see our identification cards and to sign the visitor's book. This meant that appropriate actions were being taken which ensured that people's information would be kept safe and the service protected from others who did not have the right to access the office.

Improvements were needed to ensure that the systems in place to manage medicines ensured that people received their medicines safely.

Is the service effective?

People's care records showed that care and treatment had been planned and delivered in a way that was intended to ensure people's safety and welfare. Most records viewed had been regularly reviewed and updated, which meant that care workers had been provided with up to date information about how people's needs were to be met.

Care workers had started to receive regular supervision and support to help them provide an effective service.

Is the service caring?

People said the care workers were respectful when providing their care.

Is the service responsive?

Due to the large number of people the service provided care to the provider was in the process of continuingly recruiting more care workers to help their service to be more responsive.

Records showed that where concerns about people's wellbeing had been identified the management of the service had taken appropriate action to ensure that these had been investigated and appropriate action taken.

People using the service, their relatives and other professionals involved with the service had the opportunity to complete satisfaction questionnaires. Where shortfalls or concerns were raised these were addressed

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. There were clear lines of accountability and systems in place for people to raise any concerns they may have.

The service had quality assurance systems in place and records seen by us showed that any identified shortfalls had been addressed promptly. As a result the quality of the service was continuingly improving.

The provider had been pro-active since our inspection in August 2013 and had submitted a number of action plans to rectify the concerns raised around previous areas of non-compliance. They had also set themselves clear timespans which ensured these issues were rectified as soon as possible. A new management structure had been introduced and there was more accountability in people's roles.

There was a mixed response from people we spoke with. Those who had regular carers and had been with the service for a number of years were receiving a good reliable service and had very positive comments. Those who did not have regular carers had experienced missed visits, late calls and not always receiving the care they required. We also found that people's experience of the service depended on the geographical area they lived in.

Other areas of concern raised during this visit included the supervision of staff, medication and quality auditing. The provider had been pro-active since our visit and has submitted a number of action plans on how they intend to rectify the concerns raised around non-compliance. They have also set themselves timespans to ensure these issues are sorted as soon as possible.

People using the service told us that they had had contact with management and that they were able to express their views about the service. They had been made aware of the complaints procedure and confirmed they had received written documentation during the assessment.

There were systems and procedures in place to help staff identify concerns and respond appropriately to the signs and allegations of abuse. Those spoken with added that they felt safe with the staff and that they considered they were well trained.

People we spoke with were complimentary about the service and made positive comments. Comments taken from the provider's quality assurance included, 'Her positive attitude and kind consideration gave my father and the family confidence in a situation very new to us,' 'They are very caring and kind,' 'Thank you for your help, kindness and support,' and 'We would like to say what wonderful professional and very caring person 'X' is, and to thank her and all the other caring and very kind ladies.'