You are here

Carewatch (Lancashire West & Central) Good

We have edited an inspection report for Carewatch (Lancashire West & Central) in order to remove some text which should not have been included in this report. This has not affected the rating given to this service.

Reports


Inspection carried out on 22 January 2019

During a routine inspection

Carewatch (Lancashire West & Central) was inspected on the 22,23 and 24 January 2019 and the inspection was announced. We visited the office on the first day. We arranged to visit clients on the second day and telephoned randomly selected staff on the third day to gather their views. The registered manager was given 24 hours' notice as we needed to be sure people in the office and people the service supported would be available to speak to us.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Carewatch (Lancashire West & Central) is registered to provide support with personal care. At the time of our inspection visit there were 87 people who received support.

Not everyone using Carewatch (Lancashire West & Central) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered managers, 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.

At the last inspection in March 2018, we found two breaches of regulation. We found breaches in the regulations related to safe care and treatment and good governance. We issued requirement notices for these breaches in regulation. In addition to the requirement notices we made a recommendation related to people’s capacity to consent to care.

Following the inspection in March 2018, we asked the registered manager to act to make improvements in the areas we had identified. The registered manager was required to send the CQC an action plan, outlining how they intended to make improvements. We used this inspection process carried out in January 2019 to check the action plan had been followed and improvements made.

At this inspection, we found improvements had been made. Staff had the skills, knowledge and experience required to support people with their care and support needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and documentation in the service supported this practice.

People’s care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered. Care plans held personalised information that guided staff on peoples support needs and promoted positive relationships.

Care records contained information about the individual's ongoing care and rehabilitation requirements. This showed us the registered manager worked alongside other health care services to meet people's health needs.

The service had systems to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs. New staff shadowed experienced staff members while they learnt their role.

The registered manager completed spot checks on staff to observe their work practices were appropriate and people were safe.

The registered manager planned visits to allow carers enough time to reach people and complete all tasks required. People told us they mo

Inspection carried out on 27 March 2018

During a routine inspection

The inspection of the service took place 27 and 28 March 2018. The service was given 24 hours' notice prior to the inspection. This was to ensure there would be someone available to speak with us.

Carewatch (Lancashire West & Central) is managed from well-equipped offices located in Preston. Services are provided to support people to live independently in the community. During this inspection there were 68 people who used the service.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing.

Not everyone using Carewatch (Lancashire West & Central) receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager at the service. 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.

At the last inspection we found Medication Administration Records (MARs) were not always completed in line with the company policy and best practice. We made a recommendation around this. During this inspection we looked at how the service managed people’s medicines. We found people were not being supported in line with the services own policies and procedures. Documentation around medicines management was conflicting at times.

This amounted to a breach of Regulation 12 (Safe care and treatment) 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 the report.

Risk assessments did not always contain information to adequately lessen the risks to individuals. Behaviour management plans we saw were brief and did not document how individuals were supported in line with best practice.

This amounted to a breach of Regulation 12 (Safe care and treatment) 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 the report.

We saw evidence that monthly quality monitoring was being undertaken, however the audits were not always effective. We found little information surrounding the details of issues found and how these had been rectified and lessons learned. We also noted the audit system had not identified the breaches of regulation and areas of improvement we had noted during this inspection.

These shortfalls in quality assurance amounted to a breach of Regulation 17 (Good governance) 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 the report.

During this inspection we found the principles of the MCA were not consistently embedded in practice. We found people’s capacity to consent to care had not always been assessed and information was, at times, conflicting. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible. We have made a recommendation around this.

Staff understood how to identify abuse and report it. They told us they had received training in keeping people safe from abuse and this was confirmed in staff training records. Staff told us they would have no concern in reporting abuse and were confident the registered manager would act on their concerns.

We found recruitment was safe. We reviewed staffing at the service and did not find any concerns.

We were able to see staff supervision was taking place. Staff we spoke with c

Inspection carried out on 21/10/2015

During a routine inspection

Carewatch (Lancashire West & Central) provides personal care and practical help for people who live in the community. The agency is based on a business park in the docklands area of Preston. At the time of this inspection, care and support was being provided for 103 people by a team of 64 support staff, who were assisted by a small management team. The aim of the agency is to maximise people’s independence and therefore help them to live within their own homes or sheltered accomodation for as long as possible.There is ample space to facilitate meetings, private interviews and staff training. Equipment is available for training purposes, such as a bed and moving and handling apparatus. Car parking spaces are available at the agency office. Carewatch (Lancashire West & Central) is owned by Carewest Ltd.

The last inspection of the service took place on 19 August 2013 when it was compliant with all outcome areas assessed at that time.

A visit to the agency office was conducted on 21 October 2015 by an inspector from the Care Quality Commission. The registered manager was given short notice of our planned inspection. This was so that someone would be available to provide the information we needed to see.

The registered manager of the agency was on duty when we visited Carewatch. 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 and associated regulations about how the service is run.

Records showed the staff team were well trained and those we spoke with provided us with some good examples of modules they had completed. However, some training sessions were slightly overdue, but evidence was available to demonstrate that efforts were being actively made to ensure all training was brought up to date. Regular supervision records and annual appraisals were retained on staff personnel files.

Staff were confident in reporting any concerns about a person’s safety and were aware of safeguarding procedures. Recruitment practices were robust, which helped to ensure only suitable people were appointed to work with this vulnerable client group.

The planning of people’s care was based on an assessment of their needs, with information being gathered from a variety of sources. Evidence was available to show people who used the service, or their relatives had been involved in making decisions about the way care and support was being delivered.

Regular reviews of needs were conducted with any changes in circumstances being recorded well. Areas of risk had been identified within the care planning process and assessments had been conducted within a risk management framework, which outlined strategies implemented to help to protect people from harm.

People were supported to maintain their independence and their dignity was consistently respected. People said staff were kind and caring towards them and their privacy and dignity was always respected.

Staff spoken with told us they felt well supported by the manager of the agency and were confident to approach her with any concerns, should the need arise.

The management of medications could have been better. People told us they received their medicines in a safe manner. However, we found some ommisions in the recording on the Medication Administration Records [MARs] of people we pathway tracked. We have made a recommendation in relation to this.

Inspection carried out on 9, 12, 14, 16, 19 August 2013

During a routine inspection

We visited Carewatch (Lancashire West & Central) on 9th, 12th and 14th August 2013 and spoke to people that use services and relatives on 9th, 16th and 19th August 2013. This visit was part of our scheduled programme of inspections but also to monitor improvements in area of non-compliance identified in January 2013. At our inspection in January 2013 there was noncompliance identified with outcomes 4, 12 and 21. At this inspection we saw that the agency continued to show improvement in how it delivered and monitored the quality of service delivery. We looked at outcomes 4, 9, 12, 16, 17 and 21. We found that compliance was achieved with these outcomes.

People said that they were able to influence and determine their care and that they decided on how their care was delivered.

People told us their care arrangements were flexible to support their needs and as a result of support from the agency their lifestyle had improved.

People told us that they were supported to manage their medicines and these arrangements suited their needs and circumstances.

We saw that staff were recruited appropriately and as a result people were protected from unsafe care.

We saw that there was a complaints procedure in place and people knew how to use it and who to speak to if they were dissatisfied with their care.

Inspection carried out on 28 January 2013

During a routine inspection

We spoke with seven people using the service who provided us with mixed feedback about Carewatch. They told us their privacy; dignity and independence were considered and they are given choices about the support they receive however, some of the people we spoke with were unsure regarding the effectiveness of the care planning and feedback varied regarding not knowing when staff are coming staff and who is coming.

They told us:

“It’s been hard going to be honest, very inflexible in the beginning don’t seem to be able to get themselves organised...the office seems to be the problem it’s disorganised”. “I had a girl for the first couple of months; she didn’t seem to know what she was doing”.

In relation to safety “sometimes I feel safe, other times I don’t… depends on staff” adding “20% not happy it’s down to staff”.

“I like the regular carers”.

“Think they’re fine”.

“At the moment they’re not very good as they’re short of staff” “why don’t they let me know what’s happening?”

Inspection carried out on 20 September 2011

During a routine inspection

We spoke to the director, manager and two staff in the office on the day of the site inspection. In addition we spoke to some staff and people using the service by telephone. Comments we received were all positive and included, "They are all OK, I think they give me a decent service”. Also, "They are a happy bunch and like to have a chat, I look forward to them coming”.

People we spoke to told us they thought the agency was very good in the support they provide. Comments included, “Absolutely brilliant”, “They all know what they are doing, I am confident in them”.

Staff members we spoke to told us they thought it was a good agency to work for. Comments included, “We work really well as a team”, “I feel supported by the managers, and you can always talk to them about anything”.

Other professional agencies we spoke to, such as Lancashire Social Services said they have no issues with the agency. They told us they have been involved in investigating some Safeguarding issues. They told us the agency has worked closely with them and has always participated positively in any investigation.

Staff spoken to had a good awareness of individuals care needs and the importance of treating people with respect and dignity. The manager showed us training records to support what training staff have received in respect of making sure staff understand the importance of upholding the principles of privacy and dignity. Comments from staff included, “I think it’s important to make sure people feel comfortable in their own homes, and that they can trust us to give them care in a dignified way”. A person we spoke to who uses the service told us, “The staff are always polite”.