We carried out a review of the data available to us about Careshaw Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Careshaw Ltd, you can give feedback on this service.
Careshaw Ltd is a domiciliary care service providing care and support to people living in their own home. At the time of the inspection there were 25 people using the service, 21 of whom were receiving support with personal care.
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
There were systems and processes in place to identify and manage risks associated with people’s care. There were organisational governance processes in place to monitor the quality of the service.
People and their relatives told us they felt safe with the staff who supported them. Staff had received safeguarding training and were able to demonstrate their understanding and responsibilities to reduce the risk of harm to people.
People were supported by sufficient numbers of staff who had been recruited safely. Staff had received training appropriate to meet people’s needs.
People received their medicines from staff who had been trained to safely administer medicines.
People and staff provided positive feedback on the management of the service. Systems were in place for ongoing feedback on the quality of care alongside surveys.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 03 November 2021).
Why we inspected
We received concerns in relation to care delivery and the management of concerns and complaints. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires Improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Careshaw Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
CARESHAW LTD is a domiciliary care service providing care and support to people living in their own home. At the time of the inspection there were 36 people using the service, 28 of whom were receiving support with 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
Risks to people's health, safety and welfare had been identified and risk management plans were in place. However, the plans were basic and required more detail.
People were protected against avoidable harm or abuse.
Care plans contained information about people's individual needs, preferences and routines. However, information was basic more detail was required.
Medicines were managed safely. However, guidance documents for administering medicines people only needed occasionally were basic and required more detail.
Safe recruitment practices were followed and appropriate pre-employment checks were carried out. There were enough staff employed to ensure people received timely care.
The culture in the service was positive and people were treated with kindness and respect. 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.
Management of the service had improved and audits were in place. The registered manager and provider worked in an open and transparent way. However, more time was needed to ensure systems to monitor care were fully embedded.
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 inadequate (published 20 April 2021) and there were multiple breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since April 2020. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for CARESHAW LTD on our website at www.cqc.org.uk.
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.
About the service
CARESHAW LTD is a domiciliary care service which provides care and support to people living in their own homes. At the time of the inspection, there were twenty-five people receiving care and support. 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
We found evidence of ineffective systems and processes regarding how the provider delivered and monitored the quality and safety within the service. This meant there was limited oversight of the safety of the safety of people being supported.
Risk's to people's safety were not always identified, assessed and managed. The provider's failure put
people in the service at risk of harm. Medicines were not managed safely and in line with best practice guidance.
People were not always protected from avoidable harm or abuse. Not all staff received training relating to safeguarding and did not have good knowledge of this. People were being charged for more care hours than they received.
People were not protected from the risk of infection and some staff failed to follow the national guidance about wearing Personal Protective Equipment (PPE). People did not have COVID-19 care plans in place or risk assessments for those at higher risk of adverse effects from the virus.
There were no processes in place to monitor care calls delivered for people which were often cut back in time. The culture of the service sometimes lacked professionalism. Staff and people spoke highly of the registered manager.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People did not always have person centred care plans in place. There was a lack of evidence around people’s cultural needs.
The provider had a complaints policy in place but had received no formal complaints. Some staff received end of life care, however, there were a number of staff who had not. The service supported people who were reaching or at the end of their life.
The service worked with other agencies and communicated well with both people using the service and staff. The provider had carried out criminal record checks on all staff. Staff meetings were held to discuss areas of improvement.
Staff supported people to maintain independence. Peoples feedback was regularly sought. The service sent out a regular newsletter. People told us staff knew them well and were kind and caring.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 27/03/2020 and this is the first inspection.
Why we inspected
We carried out this inspection because the service had not been inspected previously.
Enforcement
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to person centred care, safe care and treatment, safeguarding and governance.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.