Archived: Carewatch (Norfolk)

Carewatch (Norfolk) is a domiciliary service providing personal care to 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. At the time of the inspection, 158 people were receiving support with personal care.

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

The provider had ensured that effective systems were in place to protect people from the risk of abuse and avoidable harm. Risks to people’s safety had been assessed and managed well.

There were enough skilled and knowledgeable staff to complete people’s care visits. The provider had completed the required checks on new staff to make sure they were safe to work at the service.

People received their medicines when they needed them and staff took precautions to reduce the spread of infection, including COVID-19. When things had gone wrong, lessons had been learnt to improve the quality of care provided.

People were involved in making decisions about their care and they told us their care needs were met. Some people said their care visits were on occasion, at inconsistent times or late. The provider had already recognised this issue and was actively reviewing people’s care visits with the aim of improving this area.

The culture within the service was open and people and staff felt comfortable to raise concerns. When mistakes had been made, the provider had acknowledged and learnt from these to improve the care provided.

There was good leadership in place. Governance systems were effective at monitoring and driving improvement within the service and the provider worked well with other organisations for the benefit of people using the service.

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 4 July 2019). At that inspection we found the provider had not notified CQC of important incidents and this resulted in a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels, the management of risk’s to people’s safety, medicines management and people not receiving care to meet their individual needs. A decision was made for us to inspect and examine those risks.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, responsive and well-led sections of this full report.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection in August 2018, we found four breaches of the regulations and the service therefore remained in Special Measures. In response to this we met the provider to ask what they would do and by when to improve the key questions of safe, effective, caring, responsive and well-led to at least Good. At this inspection we found that some improvements had been made and the provider was no longer in breach of the four previous regulations. We have judged that sufficient improvement has been made to remove the service from Special Measures. However, the provider failed to notify us of some important incidents that had occurred at the service and therefore are now in breach of a different regulation. Some other improvements are also required as detailed below.

People’s experience of using this service: People’s medicines were not always managed safely and the provider’s systems in place to monitor this area were not fully effective. The provider had recognised these concerns and was making improvements in this area.

Improvements had been made to staffing levels which has resulted in more people receiving their care visits in line with their individual needs and preferences.

People told us the staff were kind and caring and that the care they received was not rushed. They also said they were treated with dignity and respect.

People told us they now saw more regular staff which helped them build caring and trusting relationships with each other.

Systems were in place to protect people from the risk of abuse and avoidable harm and they used good practice to reduce the risk of the spread of infection.

The necessary checks had been made to ensure that staff working at the service were of good character.

People were supported to maintain their health where necessary and staff worked with other healthcare professionals to help people achieve this.

People’s complaints were listened to and acted upon to improve the quality of care they received.

People were involved in the planning and delivery of their care. Their views were regularly sought and acted upon.

Staff had received enough training in most areas to provide people with safe care that met their individual needs and preferences, although some improvements were required to the way they managed people’s medicines.

People’s consent had been sought before they were provided with care and if they were unable to give this, staff had acted appropriately to ensure care was provided in the person’s best interests.

Rating at last inspection: The rating at the last inspection was overall Requires Improvement and Inadequate in the key question of Well-Led (published November 2018).

Why we inspected: This was a planned inspection based on CQC’s methodology for inspecting services in Special Measures.