Archived: New Care (Exeter)

Updated 13 May 2015

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 12, 16 and 23 March 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to arrange to visit some people that used the service.

The inspection team consisted of an inspector, pharmacist and two experts 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. Before the inspection we looked at all the information we held about the service including all notifications sent by the provider.

We spoke with 43 people in total, which included people using the service, their relatives and a friend. We looked at 17 care records which included medication records for 12 people. We interviewed 17 staff, which included a director in the company, the branch manager, care workers and office based staff such as care co-ordinators, field care supervisors and staff trainers. We contacted commissioners, social workers, GP surgeries and therapists and received feedback from three of them.

Updated 13 May 2015

This inspection took place on 12, 16 and 23 March 2015 and was announced. We had previously inspected the service in August 2014 because of concerns about the service and found breaches of regulations regarding people’s care and welfare and staffing. This was because the service did not have sufficient staff which resulted in late and missed visits.

Newcare Exeter is a domiciliary care agency that provides personal care and support for people in their own homes, including people living with dementia, and with care needs and physical disabilities. At the time of our visit, they agency provided care for 105 people in their own home and employed 46 care staff.

The service is required to have a registered manager, the previous registered manager left at the end of 2014 and was replaced by a manager who was already working at the service. The manager has not yet registered with the Care Quality Commission but said they plan to do so. 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 this inspection we found some improvements had been made. The branch manager reported they had recruited enough staff to meet people’s needs and there were very few cancelled visits, all of which were discussed and agreed in advance. However, high levels of staff sickness meant people still reported having some late visits and lots of different care workers visiting them, particularly in the evenings and at weekends.Further improvements were needed in staffing to ensure there were sufficient numbers of suitable staff at all times to meet people’s health and welfare needs.

People reported very variable experiences of communication with the agency’s Exeter office, with rotas often being sent out late, which were often incomplete and with messages sometimes not being passed on. Staff also reported difficulties with communication in the office and late and incomplete rotas. Further improvements were needed in systems to ensure better organisation of the service and improved communication between people, care workers and office based staff. Although complaints received were thoroughly investigated, and dealt with there was a recurrence of similar themes because of underlying staffing and system issues that needed to be further improved.

Most people were happy with the care provided by staff who visited them and said they were treated with dignity and respect. People’s comments included, “I am very happy, they look after me very well” and “They are very kind to me and I have no real problems”.

People’s care and health needs were assessed and care plans included detailed information for staff about people’s care needs. These were reviewed and updated regularly as people’s care needs changed.

A robust recruitment process was in place to make sure people were cared for by suitable staff. Staff were aware of signs of abuse and knew how to report concerns and were confident these would be investigated. Improvements had been made in medicines management to ensure people received their prescribed medicines on time and in a safe way. The provider had increased the monitoring of care workers through regular spot checks and people ‘s care records were regularly updated as their care needs changed.

The agency had comprehensive staff training and carried out regular appraisal and supervision with staff and supported them with their professional development. There were good quality monitoring systems in place and the provider was aware of the areas for improvement we found and were taking further steps to improve them.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Throughout the report we have explained how these correspond to the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which came into force on 1 April 2015. You can see what action we told the provider to take at the back of the full version of this report