Archived: Carewatch (Harrow, Hillingdon & Ealing)

Updated 8 March 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 provide a rating for the service under the Care Act 2014.

This inspection was carried out by one inspector and was supported by an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to make sure they would be available for our inspection.

Before we visited the service we checked the information that we held about the service and the provider including notifications and incidents affecting the safety and well-being of people.

Some of the people being cared for were older people who had dementia or a specific medical condition and could not always communicate with us and tell us what they thought about the service. Because of this we spoke to family carers and asked for their views about the service and how they thought their relatives were being cared for.

We spoke with seven people using the service, three relatives, six staff and the branch manager. We reviewed seven people’s care plans, six staff files, training records and records relating to the management of the service such as audits, policies and procedures.

Updated 8 March 2016

We undertook an announced inspection on 12 January 2016 of Carewatch (Harrow, Hillingdon and Ealing). The service is registered to provide the regulated activity personal care. Carewatch (Harrow, Hillingdon & Ealing) is a domiciliary care service for people living in their own homes and run by Graham Home Care Limited. The service has around 280 people who use the service and 176 care workers working for them.

The service did not have a registered manager in post. 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. There was a branch manager in place however he also told us that he would be leaving the service and the provider would be looking to recruit another manager who would apply to be registered with us.

At our last inspection on 27 August 2014, the services met the regulations inspected.

During this inspection, we found people experienced a lack of consistency in the care they received. Some people did not have regular care workers and were also not aware of which care worker was coming to support them.

Although there were some positive aspects to the service such as people were being cared for and supported to have access to healthcare services, we found failings in four of the five domains resulting in people who used the service receiving lower standards of care than they should.

Individual risk assessments were completed for each person. However, the assessments contained limited information and some areas of potential risks to people had not been identified and included in the risk assessments

Care plans were not person centred and did not reflect the appropriate support people would need in relation to sometimes complex health and mobility needs.

Training records showed staff did not receive regular and appropriate training for them to gain the necessary knowledge and skills they needed to carry out their roles and responsibilities effectively.

People using the service and relatives told us they felt the care workers were not sufficiently trained to provide the care and support people needed.

There were some arrangements in place to obtain, and act in accordance with the consent of people using the service. However care plans did not contain any information about a person’s mental capacity and levels of comprehension especially for those people who may have dementia and are unable to verbally communicate.

The current systems in place were not robust enough to monitor and improve the quality of the service being provided to people using the service. Although the provider had conducted audits to assess the quality of the service and identified areas of improvement, there were no effective measures put in place by the provider to address the areas that needed improving and the service continued to provide a poor service.

There were suitable arrangements in place to manage medicines safely and appropriately.

Feedback from people and their relatives indicated that people were being treated with dignity and respect. Care workers had a good understanding and were aware of the importance of treating people with respect and dignity and respecting their privacy. People were supported to maintain good health and have access to healthcare services and received on going healthcare support.

Appropriate checks were carried out when staff were recruited.

People using the service were encouraged and supported with their independence.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.