Archived: Carewatch (Windsor)

Updated 10 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 to provide a rating for the service under the Care Act 2014.

This inspection took place on 11 and 12 April 2017 and was announced. The service was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure someone would be available to assist us.

The inspection visit was carried out by one inspector. Two experts by experience made telephone calls to a sample of people who used the service, to ask for their views about care. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed notifications and any other information we had received since the last inspection. A notification is information about important events which the service is required to send us by law. We did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Instead, we gave the registered manager opportunity tell us about what the service does well and any improvements they intended to make.

We contacted four social care professionals and 28 members of staff, to seek their views about the service. Six relatives and 22 service users provided feedback about Carewatch Windsor.

We spoke with the registered manager and six staff members. We checked some of the required records. These included five people’s care plans, four staff recruitment files, a sample of policies and procedures, medicines records, monitoring and auditing documents.

Updated 10 June 2017

This inspection took place on 11 and 12 April 2017. It was an announced visit to the service.

We previously inspected the service in August 2016. The service was not meeting all the requirements of the regulations at that time. Following that inspection, we asked the provider to make improvements to how complaints were handled, monitoring of the service, staff support including training and supervision and informing us about notifiable occurrences. The provider sent us an action plan which outlined the improvements they would make. We also recommended improvements be made to medicines practice, accident and incident reporting, best interest decision making and use of mobile phones whilst staff were supporting people.

Carewatch Windsor provides support to mainly older people in their own homes. Two hundred and forty eight people were receiving a service at the time of the inspection.

The service had 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.

We received positive feedback about the service. Comments from people included “I’m extremely happy with the help that I get from Carewatch.” A relative said “They’ve made a lot of difference to mum especially with her confidence.” Other people said “Nothing is too much trouble for them at all,” “It’s nice to know that they’re here for me” and “I’m pleased to open the door for them, they’re all very nice staff.”

People we spoke with told us they felt safe. Comments included “Mum feels very safe with them and if she’s happy, I’m happy,” “I feel very safe with them. It’s good to know that they’re here for me,” “I definitely feel safe when they’re here” and “I always feel safe with them.”

We found improvement had been made to recording of when medicines had been given to people. Improvement had also been made to best interest decision making processes where people lacked mental capacity. The service had obtained copies of power of attorney documentation, where appropriate, so it was clear to see who had authority to make decisions on behalf of service users. No one raised concerns with us on this occasion about staff using their mobile phones whilst they supported people.

There were sufficient staff to meet people’s needs. They were recruited using robust procedures to make sure people were supported by staff with the right skills and attributes. People spoke positively of their regular care workers. For example, “The carers are very nice, very kind to me,” “All that come seem quite pleasant,” “The carers are lovely” and “The girls are very good, very kind to me.” People told us they did not always know who would coming to support them. We have made a recommendation for the service to follow good practice by providing people with staffing rotas.

Some people told us they received a different standard of care at weekends. Comments included

“The weekend staff don’t wash me properly, bit slap dash and they rush through things. They just do the minimum required. One girl kept her coat on whilst she was washing me which is not the best when you’re naked.”

There were systems for inducting, training and supervising staff. However, some care workers did not feel they received the support they needed whilst out in the community.

Accidents had not always been properly recorded at the service. For example, injuries were not always noted and information had not consistently been provided about actions to prevent recurrence.

People told us they had mixed responses to how their complaints were handled. Some people were satisfied with the responses they received. For example “Carewatch have a new complaints officer. She is wonderful. She is so prompt, dealt with my concern within two hours. This has never happened before. We are so happy that now we have someone in Carewatch Windsor that listens.” Another person told us “I’ve had a moan and they’ve dealt with it.” Other people were less pleased and said “I ring the office but nothing happens, I spoke with a lady who deals with complaints and it got better for a while then it deteriorated again” and “My daughter has tried to complain but never got anywhere.”

The service had been managed by a different registered manager since our last inspection. A social care professional said they had made “Huge improvements” at the service in that time. Staff we spoke with felt positive changes had been made to the culture of the service. Improvement had been made to notifying us about reportable occurrences. However, we were not promptly provided with additional information we asked for, to tell us what had happened and actions taken by the service.

We found breaches of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to good governance of the service, handling of complaints and safe care and treatment.

You can see what action we told the provider to take at the back of the full version of this report.