Background to this inspection
Updated
26 May 2022
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
This was a focused inspection to check on a concern we had about risk management and staffing levels.
Inspection team
The inspection was completed by two adult social care inspectors and an Expert by Experience who made phone calls to people using the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was not a registered manager in post. The provider was recruiting to the registered manager role. There was an acting manager in post.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 8 April 2022 and ended on 22 April 2022. We visited the agency office on 8 April 2022.
What we did before the inspection
We reviewed information we had received about the service since they were registered, including notifications. Notifications are information about specific important events the service is legally required to send to us. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We used all this information to plan our inspection.
During the inspection
We spoke with six people who use the service and three people’s family members and sought feedback from the local authority and professionals who work with the service. We spoke with six care staff members, the manager and four office staff members. We also spoke with the provider’s nominated individual and the provider’s area manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records, including four people’s care records and medication records. We looked at four staff files in relation to recruitment and records relating to staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
26 May 2022
About the service
Carewatch (Isle of Wight) is a domiciliary care agency which provides support and personal care to people living in their own home. 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. At the time of our inspection 74 people were receiving a regulated activity.
People’s experience of using this service and what we found
Although people that received care from Carewatch (Isle of Wight) were generally happy with the care they received we found shortfalls in the safety and management of the service which placed people at risk of harm.
The provider’s quality assurance processes were not effective and had failed to identify concerns we found and improve the quality and safety of the services provided.
Not all risks for people had been fully assessed and plans put in place to mitigate those risks as far as possible. Where risk assessments were in place a lack of staff meant that they were not always followed. Medicines had not always been managed safely.
Recruitment procedures were not always effectively followed to ensure only suitable staff were employed and we have made a recommendation to support improvement.
People told us they felt safe when receiving a care service and staff and the manager were aware of their safeguarding responsibilities.
Staff told us they always had enough Personal Protective Equipment (PPE) and had not experienced a shortage during the COVID-19 pandemic. They described how and when they would use PPE which reflected appropriate current guidance. Care staff told us they were regularly testing for COVID -19. The manager said they were now seeking evidence from staff to confirm completion of testing and test results.
People and their family members were all positive about the caring nature of the staff. People told us they were always treated with dignity and respect. People felt able to express their views and request additional tasks if required.
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 good (published 11 May 2021).
Why we inspected
The inspection was prompted in part due to concerns received about risk management and staffing levels. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. During the inspection we identified that the existing rating for caring was no longer correct and we therefore expanded the inspection to also cover this key question.
For those key questions not inspected, (effective and responsive) we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, caring and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carewatch (Isle of Wight) on our website at www.cqc.org.uk.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to risk assessment, medicines management and ensuring the quality of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.