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Archived: Carewatch (Derby) Good

This service was previously registered at a different address - see old profile

Reports


Inspection carried out on 23 August 2018

During a routine inspection

We inspected this service on 23 August 2018. This inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived.

At our previous inspection on the 6 and 13 June 2017 the provider was not meeting one of the regulations that we checked and was in breach of Regulation 11 of the Health and Social Care Act (Regulated Activities) Regulations 2014.This was in relation to consistently ensuring people’s capacity to consent to their care was undertaken when needed. We identified that when relatives had confirmed they could legally make decisions on behalf of their relation, this had not been checked by the provider to ensure people’s rights were upheld. At our previous inspection other improvements were also needed. This was because some people did not have risk assessments in place where needed and their care plans did not always reflect their current support needs. The provider had not identified these areas for improvement within their quality monitoring checks. At this inspection we found that improvements had been made. We saw that people were protected under the Mental Capacity Act and their care plans and risk assessments reflected their support needs.

Carewatch (Derby) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. Not everyone using Carewatch (Derby) 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 take into account any wider social care provided.

Carewatch (Derby) provides personal care to people in their own homes. At the time of our inspection a total of 108 people were using the service, of these 99 people were in receipt of personal care support.

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. The registered manager was not available on the day of our inspection visit due to planned annual leave.

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 systems in the service supported this practice. Where people needed support to make specific decisions, their capacity had been assessed. Information was provided to staff to enable people to be supported in their best interests when needed. Risks to people were managed to reduce potential hazards and people’s care plans reflected their current needs and preferences.

People received their calls as agreed from a consistent staff team. People were supported by staff who understood what constituted abuse or poor practice and their role in reporting concerns. Checks on staff were done before they started work to ensure they were suitable to support people. Medicines were managed safely and people were supported to take their medicine when needed.

People were supported by trained staff who were provided with supervision by the management team to monitor their conduct and support their professional development. When needed, people were supported to maintain their dietary requirements and preferences and to access healthcare services.

People liked the staff and confirmed that the staff treated them with respect and ensured their privacy and dignity was upheld. The provider sought the opinions of people and their representatives to bring about improvements. People knew how to complain and we saw when complaints were made these were addressed. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement. The provider u

Inspection carried out on 6 June 2017

During a routine inspection

This inspection took place on 6 and 13 June 2017 and was announced. Carewatch (Derby) is registered to provide personal care to people living in their own homes. At the time of our inspection, 139 people were receiving personal care.

The service was last inspected on 15 and 17 December 2015, when they were rated as Requires Improvement.

The service had a registered manager in post at the time of our inspection, who was present during our inspection. 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.

People were not consistently protected from the risk of avoidable harm. Risks associated with personal care were not always identified, so appropriate protective measures were not always in place to minimise the risk of avoidable harm. The provider’s auditing systems did not identify this shortfall to enable action to be taken.

Appropriate arrangements were not in place to assess whether people were able to consent to their care. The provider was not meeting the legal requirements of the Mental Capacity Act 2005 (MCA).

People were happy with staff who provided their personal care. They were cared for by sufficient numbers of staff who were suitably skilled and knowledgeable about people’s needs. People were supported by staff in a caring way, which ensured they received personal care with dignity and respect.

The provider took action to ensure that potential staff were suitable to work with people needing care. Staff received supervision and had checks on their knowledge and skills. They also received training in a range of skills the provider felt necessary to meet the needs of people.

The systems for managing medicines were safe, and staff worked in cooperation with health and social care professionals to ensure that people received appropriate healthcare and treatment in a timely manner.

People were involved in their care planning and delivery. The support people received was tailored to meet their individual needs and wishes. People, their relatives, and staff felt able to raise concerns or suggestions in relation to the quality of care. The provider had a complaints procedure to ensure that issues with quality of care were addressed.

Systems were in place to monitor the quality of the service provided and check if people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care. Checks were undertaken on personal care provision so that action could be taken to improve the service.

We found one breach 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.

Inspection carried out on 15 and 17 December 2015

During a routine inspection

This inspection took place on 15 and 17 December 2015. The inspection was announced, and we gave the provider 48 hours’ notice to ensure there was a manager available to assist with the inspection process.

Carewatch (Derby) provides personal care to adults living at home in Derbyshire. At the time of our inspection there were 124 people receiving care. People using the service have a range of needs, including physical disabilities and dementia. 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.

People did not always receive their care calls when they felt they should, and felt they were not always told when staff were running late. The provider was planning to a new system to address this, but this was not in place at the time of our inspection visit.

Medicine administration was not always recorded accurately. The monthly audit of medicine records picked up most errors in the records we viewed, but did not consistently identify where there were errors in recording.

People told us they felt safely cared for. Staff had a good understanding of the risks involved in people’s care. One person told us they felt this was not always the case. We brought this to the attention of the provider and the local authority so this could be investigated.

Staff recruitment practice and procedures ensured people were supported by staff who were suitable to work with vulnerable people. Staff received induction, ongoing training and regular supervision to ensure they had the skills the provider required to deliver care. Staff were knowledgeable about people’s needs and preferences for care.

Consent to care was not consistently sought in line with the Mental Capacity Act 2005. Although staff understood what was required of them, some people did not have the necessary capacity assessments or best interest decisions documented as required by law.

People were supported by staff that treated them with dignity and respect. People felt staff cared for them and understood their care needs.

The provider did not always review care or seek people’s views about their care service as often as they said they would. There was a complaints policy and procedure in place which people knew about, but they did not always feel their complaints were resolved well.

Everyone we spoke with was happy with the staff who supported them, but some people were not happy with communication from the service, specifically in relation to late care calls.

Staff felt well supported by the registered manager, who understood their duties and responsibilities.

The systems in place for auditing the quality of the service provided did not always identify issues. However, where issues were identified, we saw the provider made changes to the service to improve the quality of care.

Inspection carried out on 07 August 2014

During a routine inspection

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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced at short notice, to ensure there was a manager available to assist with the inspection process.

Carewatch Derby provides personal care to people in their own homes. At the time of our inspection the service was supporting 112 people. 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 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 our last inspection of 4 September 2013, the service was not meeting legal requirements required for care and welfare. This meant that people were not receiving safe or appropriate care because some calls had been missed and the provider did not have sufficient information about the risks to people and how those risks would be managed. Following the last inspection the provider had told us what actions they had taken to ensure that the service improved. During this inspection we found that risk assessments were in place where a risk had been identified, but there continued to be some concerns about how people’s care was being delivered. There were examples of late care calls, which meant people did not always receive their care at the agreed time in accordance with their plan.

People who used the service gave mixed comments about the delivery of care and the support they received. This demonstrated that the provider had further work to do to ensure people received good quality care at all times.

The provider monitored the quality of the service and had developed action plans to address any shortfalls where deficits were identified.

Staff vacancies meant that people had not always received their care calls when they had agreed them, but there was an active recruitment drive taking place.

Staff recruitment procedures were robust and effective in ensuring that staff were suitable to work with vulnerable people, and induction and training of staff was provided. This ensured staff had the necessary skills and knowledge to meet people’s needs.

Inspection carried out on 4 September 2013

During a routine inspection

Most people we spoke with were happy with the care that they received. One person told us "They do everything I need and if they have the time a little bit extra too". We did, however, identify that people's needs were not always being met as calls had been missed. The provider did not have sufficient information about risks people who used the service may face and how those risks would be managed.

We found that the provider had appropriate recruitment procedures in place when staff were recruited and that these procedures were being followed.

We found that the provider had sufficient numbers of staff employed to meet the needs of people who used the service.

We found that people who worked for the provider were being supported through supervision and training. We saw that staff received a thorough induction training which covered the Skills for Care common induction standards.

Inspection carried out on 16, 28 January 2013

During an inspection to make sure that the improvements required had been made

We visited Carewatch (Derby) to follow up on two areas of non-compliance from our previous visit. We also responded to concerns raised by the local authority about the Telephone Recording System showing that only 55% of visits to people using the service were being carried out. We did not speak to people who use the service during this visit but did speak with the registered manager and other staff and we reviewed documents held by the provider.

We found that the provider had amended the safeguarding training they provided to their care workers so that it included guidance on local reporting arrangements. We also found that the safeguarding knowledge staff had was much improved on our previous inspection.

We found that the provider was now notifying the Care Quality Commission of important events that affected the health, safety and welfare of people who used the service.

Inspection carried out on 6, 10 September 2012

During a routine inspection

People told us they felt able to express their views and some people had been involved in making decisions about their care and treatment. One person said that the care workers “did more than they should” when they visited. People who use the service were highly complimentary about some of the staff, one person saying the staff were “on the whole caring kind and considerate”.Care workers who were employed by the provider had appropriate checks undertaken before they started work. Care workers received training and supervision that allowed them to carry out their role. However, three out of four care workers could not provide adequate information about types of abuse, possible signs of abuse or local authority reporting arrangements. The provider was not notifying the CQC of important events that affecting them delivering a service, such as safeguarding incidents or deaths of people who used the service.