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Coastal Care North East Redcar and Cleveland Requires improvement

The provider of this service changed - see old profile

We are carrying out a review of quality at Coastal Care North East Redcar and Cleveland. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 6 January 2020

During a routine inspection

About the service

Carewatch Redcar and Cleveland is a domiciliary care service providing personal care to 83 people in their own homes.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Medicines were not always managed safely and accurate medicines records were not kept. Although people told us they felt safe, risk assessments were not always in place. Therefore, staff did not have all the information necessary to minimise risk.

There were enough staff to meet people’s needs. People told us staff were sometimes late to calls and did not always call to let them know. Staff were not always given the opportunity to meet people before attending care calls. They also did not always have all the necessary information they needed about the person in advance.

New staff were not always recruited appropriately. The provider had not always obtained a full employment history from staff before hiring them but was conducting other pre-employment checks.

The provider did not ensure care plans contained relevant information. They did not include full details of people's health needs and conditions, their preferences and views in relation to their care. This meant staff did not have access to all the information necessary to provide safe care.

The provider’s quality assurance checks had not identified errors in records or missing information.

Staff had the skills and knowledge to meet people’s care needs. Staff training was being reviewed and updated and a new training officer had been appointed to oversee this. Staff supervision meetings had not been happening regularly but the new management team were addressing this. Staff we spoke with felt supported.

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

The provider was not correctly recording mental capacity assessments or best interest decisions. We have made a recommendation about this.

The provider worked with other agencies to ensure they received professional advice and support when needed. Care workers respected and promoted people's privacy and dignity. Complaints were handled appropriately.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 9 January 2019). The service remains rated requires improvement. This service has now been rated requires improvement for two consecutive inspections.

At the last inspection there were breaches of two regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of two regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to managing risk, safe management of medicines and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 20 November 2018

During a routine inspection

This announced inspection took place on 20, 28, November and 5 December 2018. This was the first rating of the service since registering with us in December 2017.

Carewatch Redcar and Cleveland is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of inspection, there were 88 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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 present and was in the process of deregistering and a replacement manager was in post at the service during our inspection and had begun registering with us.

Medicines were not always, recorded or managed safely. We found issues with the records and auditing of medicines. Staff training regarding medicines was not up to date.

A programme of audits were carried out by the manager. However, these were not always effective as we found issues with medicines that were not identified in audits.

Communication systems were in place for staff and team meetings. However, these were not recorded. We made a recommendation to keep records of outcomes following staff meetings.

Accidents and incidents were recorded in various places however, there were no robust monitoring or recording systems in place to monitor accidents and incidents.

Feedback from people regarding the management of the service was mixed however feedback from staff was positive and they felt supported.

People’s nutrition and hydration needs were met and they were supported to maintain a healthy diet. Where needed, records to support this were detailed.

Partnership working was in place with other professionals, including health care professionals and community nurses. Specialist consultants were involved in people’s care, as and when this was needed.

People’s personal risks had been identified and more detailed risk assessments had been written to give staff the necessary guidance on how to keep people safe.

Staff training reflected people’s needs. Staff gave us positive feedback about their training.

People were supported by sufficient numbers of staff to meet their needs. Rotas’ showed there were consistent numbers of staff to meet people’s needs.

People were supported to access information in a variety of formats and adaptations could be made to suit individual needs.

People were supported by kind and caring staff. The feedback from people and their relatives was positive about the staff attitude and their caring nature.

Staff were employed safely and pre-employment checks were carried out on staff before they began working in the service. Staff were supported through an induction period. They received training and supervision from the manager together with an annual appraisal.

People were supported to maintain their independence by staff who understood and valued the importance of this.

Care plans were person centred regarding people’s preferences and were personalised. Person centred means that a person’s preferences are respected and valued when planning and delivering their care and support.

People could complain if they wished to and procedures were in place to support this.

No-one was receiving end of life are at the time of our inspection however, arrangements were in place for people.

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

Notifications of significant events were submitted to us in a timely manner by the manager.

We found two breaches of The Health and