Background to this inspection
Updated
1 November 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by an inspector and 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. Their area of expertise was care of older people. They made telephone calls to people who use the service and relatives.
Service and service type:
This service is a domiciliary care agency. It provides personal care to people in their own houses and flats. It provides a service to older adults and younger adults who have physical disabilities, mental frailty and or end of life care needs.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that the registered manager would be in and available to support the inspection.
Inspection site visit activity started on 4 April 2019 and ended on 10 April 2019. We visited the office location on 4 and 5 April 2019 to see the manager and office staff; and to review care records and policies and procedures. On the 10 April 2019 we sought further feedback and reviewed the information we had gathered at the office visit.
What we did:
¿Prior to the inspection we requested and received a Provider Information Return (PIR). Providers are required to send us key information about their service, what they do well and improvements they plan to make. This information helps support our inspections. Throughout the inspection we gave the provider and registered manager opportunities to tell us what improvements they had planned.
¿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 spoke with 11 people who used the service and seven relatives. We received written feedback from two people and four relatives.
¿We sent 50 emails to staff and 10 emails to health and social care professionals to seek feedback about the service.
¿When at the office we spoke with the registered manager, a director of the company and two staff.
¿We reviewed nine people’s care records.
¿We looked at five staff recruitment and training records.
¿We read incident and accident records, complaints and complements.
Updated
1 November 2019
About the service:
Carewatch (Mid Bucks) is registered to provide personal care to people living in their own homes. At the time of the inspection 92 people were being supported with personal care. The main office is located in the market town of Wendover.
People’s experience of using this service:
¿People and their relatives gave us positive feedback about how they had been supported. Comments included “They’re very nice ladies. It helps me a lot really,” “The carers themselves are brilliant. They’re fantastic girls. They know straight away how I am, even if I tell them otherwise” and “I’ve got a regular one and got to know her. She’s very good.” Another person told us “All carers (staff) are kind and friendly, it is not just a job of work.”
¿People were not always supported to have maximum choice and control of their lives and staff did not always support in the least restrictive way possible; the policies and systems in the service did not always support this. We found some people were subjected to restrictive practice, for instance had bed rails in place. We checked if the service had followed the code of practice for the Mental Capacity Act 2005, we found they had not ensured this was followed for all the people who had equipment in place which restricted their movement. We have made a recommendation about this in the report.
¿Systems were in place to monitor the service provided. Feedback provided by people, relatives and staff was used to drive improvement to the service. The service had recently reviewed the processes in place to support people with their medicines.
¿Prior to people receiving care and support, an environmental risk assessment was carried out. Risks associated with people’s medical conditions were assessed and staff had access to additional guidance on how to minimise the likelihood of harm. However, records showed that additional risk assessments were required for the use of bed rails and the risk of pressure damage to skin. We found these were not routinely in place. We have made a recommendation about this in the report.
¿People were supported by staff who had been employed following a robust recruitment process to check their suitability and safety.
¿People were cared for by staff who were assisted to keep their skills and knowledge up to date and received support from a line manager.
¿Where required people were supported with maintaining their hydration and nutritional needs.
¿People told us they felt involved in decisions about their care and support. People told us “The supervisor comes every so often, putting new papers in the book and checking on the carers. They ring me up and go through a questionnaire with relevant questions,” “There’s a questionnaire over the phone normally. A supervisor takes certain papers out of the folder, we have a chat” and “They visit and ring me up as well.”
¿Staff were aware of people’s communication needs. Where required picture cards were used to support people to express how they were feeling.
Rating at last inspection:
The previous inspection was carried out on 28 September 2016 (Published on 4 November 2016). The service was rated Good at the time.
Why we inspected:
The inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Inspections will be carried out to enable us to have an overview of the service, we will use information we receive to inform future inspections.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk