The Care Quality Commission

Archived: Caretime Services Devon Office

Unit 2, 11 West Street, Okehampton, Devon, EX20 1HQ (01837) 54167

Provided and run by:
Caretime Services Limited

All Inspections

5 November 2012

During an inspection looking at part of the service

Our inspection of August/September 2012 found that people were not happy with the way the agency handled complaints, some of the care provided and contacts with the agency office. The agency produced a plan of how they would improve and we met with them to discuss the plan.

During this unannounced inspection of the agency we contacted two people who used the service. They confirmed that the agency was actively seeking their opinion about the service and following up on any concerns or complaints. One person told us, "I have had good things to say about the agency. All in all I am more than satisfied". Another person said "They've definitely stepped up".

We saw the results of 30 telephone conversations the manager had with people and how the people's comments were followed up. Those records strongly indicated that people felt able to give their opinion and most responses indicated that the service was considered either "excellent" or "good". We saw that staff performance was being more closely managed, that some staff roles had changed and staff were happy with the changes.

We were shown an improvement in the way complaints were handled in that a computerised system highlighted when any action around a complaint had to be completed. The manager was also discussing with staff better ways for comments and requests to be managed. She told us 'The support I've had (from the organisation) has been brilliant'.

28 August and 5 September 2012

During a routine inspection

Meetings were held under the Devon County Council multi-agency safeguarding procedures in June and July of 2012 following concerns raised about Caretime Services Devon. Those concerns related to the way aspects of the service were monitored and staff performance within the Exeter area of the service provision. The outcome of the process indicated that essential standards were not met by the agency. The agency was responsive to the concerns raised at the meeting and wrote to us and told us how they intended to improve.

We conducted an inspection of the service, with an unannounced visit to the agency office on 28 August 2012 and 10 September 2012 and an announced visit to the agency office on 5 September 2012. The announced visit was to ensure that a senior person from the organisation could be present.

We tried to contact every person using the service in the Exeter area and we were able to speak with 32 of the 53 people who used the service, or their families. We also visited one person using the service and a care worker and agency coordinator who were meeting to discuss the carer's work.

There were many positive comments about the service including,'Great'. No problems ' she has the same carer who turns up on time. Any problems would be quickly sorted by the office"; 'Excellent care. Very respectful' and 'Excellent ...very pleased...we have become friends...they stick to the rota'.

However there were many negative comments. These included, "I have told the office several times (including last week) but it has made no difference"; "I am given a weekly rota but this is not generally adhered to. I would appreciate it if advised when carers are running late" and "When I asked for a carer not to be sent they have turned up any way".

There were many positive comments about the care workers but again, many mixed comments such as, "The carers are not too bad'. This person said that care workers did not always have the experience to recognise when his father's catheter was blocked. Two people cited concerning information about the conduct of care workers.

The agency arrangements for training and supervising care workers appeared robust, but based on people's comments and our findings we found that this did not always translate to a good experience for people. The agency arrangements for the handling of comments and complaints did not prevent or reduce the possibility of unsafe or inappropriate care as some were not responded to at all or within a reasonable timescale.

25 April 2012

During a routine inspection

This was a planned unannounced inspection but we also looked at whether the action plans following inspections in September and November 2011, where we found non compliance, had been completed and the outcomes for people improved.

We conducted an unannounced visit to the Caretime Services Devon office on 25 April 2012. We had visited four people as part of the November 2011 inspection. At this inspection we telephoned 10 people who used the service (chosen randomly by us) and saw the results of the agency's 71 monitoring telephone calls to people in April 2012. We spoke to two care workers and looked at different documents/records, such as training, complaints, care plans and staff supervision.

People told us that they were treated with respect and dignity. There was no concern over the timekeeping of care workers or the number and continuity of care workers, as there had been previously. Care plans provided information on people's needs, how to support them to be independent, where this was possible and the care they needed. We were told how care workers had arranged health care for people when they had been worried about a person's health. Most people thought they were competent and knew what they were doing.

The agency was ensuring that people were safeguarded from abuse through staff training and more robust systems to ensure that information was passed to the appropriate agencies in a timely way. One person said "I have implicit trust in them".

There were many improvements in the quality monitoring of the agency and people were regularly consulted, felt able to complain if necessary and information, such as incidents and complaints, were used toward continuing improvement.

23 November 2011

During an inspection in response to concerns

We received information from the local authority safeguarding team that Caretime Services Devon had informed them of two incidents, on 7 November 2011, which raised serious concerns about people's safety and wellbeing. It was subsequently confirmed that both people were safe. However, it was felt that the agency had not acted within a reasonable timescale to protect the two people.

We looked closely at how the agency had acted in each case where concerns had been raised. We conducted a visit to the first person's home on 23 November 2011 to meet them and their family carer and look at records of their care. We also visited the agency office to look at records pertaining to the events prior to that safeguarding alert being made. At our request the agency provided a record of how the second concern had been managed.

The one person we spoke with said they did feel safe using the agency although they listed some complaints they had about the service provided.

We found from this inspection that the agency was not responding within a reasonable timescale to concerns which might indicate serious abuse.

We found from this inspection that the way the agency operates does not ensure that people receive a safe and effective service.

6 September 2011

During a routine inspection

As part of our inspection of this agency we visited four people who use the service and had telephone conversations with ten others, the last being 20 September 2011. We conducted an unannounced visit to the agency premises on 6 September 2011. Previously we had been provided with people's opinion of the service from the agency's April 2011 surveys, actions taken to address concerns expressed from the surveys and a list of the people who had complained to the service.

Without exception people told us that they are always treated with respect and dignity and that most care workers do all they can to be flexible in their work so as to meet the person's needs. One person said: "Carers are reliable, kind and very discreet". We were told that care workers usually arrived on time and stayed as long as they were scheduled to do so. However, there were a small number of times when the care worker did not arrive and there was a strong theme of lack of continuity of care workers and changes to the original schedule provided for people. Some people did not mind many different care workers visiting but some were very unhappy about it. Those people's family/carers had reduced confidence in the service as care workers could lack individual knowledge about the person for whom they were delivering care. Care planning and risk management documents did not always relate to the person's current needs and therefore there was increased reliance on care workers individual knowledge of the person, which without continuity of care might not be sufficient.

People are protected through the agency's policies, procedures and arrangements, including safe recruitment of staff and training in how to protect vulnerable adults from abuse.

A health care professional had been impressed by end of life care provided by agency care workers and people were very satisfied with the standards of personal care, such as bathing, they had received. Care workers receive training and supervision of their work in a consistent way.

People's opinion of the service is surveyed; the standard of care delivered is monitored and complaints are investigated. However, the agency's quality monitoring arrangements do not always translate to the standard of service people want.