Background to this inspection
Updated
14 July 2017
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 was 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 over three days on 16, 17 and 18 May 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to ensure that staff were available in the office, as well as giving notice to people who received a service that we would like to visit them. On the 18 May we spent time visiting people who used the service in their homes.
The inspection was undertaken by one adult social care inspector and an expert 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 checked the information that we held about the service. We looked at any notifications received and reviewed any information that had been received from the public. A notification is information about important events, which the provider is required to tell us about by law. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also contacted the local authority contracts quality assurance team to seek their views and we used this information to help us plan our inspection.
We used a number of different methods to help us understand the experience of people who used the service. During the inspection we visited three people at home and met with three people at the provider’s office. The expert- by- experience spoke with people over the telephone to seek their views about the service, including 19 people and four relatives.
We looked at a number of records during the inspection and reviewed five care plans of people supported by the service. Other records reviewed included staff training records and records relating to the management of the service such as policies and procedures, rotas, complaints information and meeting minutes. We also inspected three staff recruitment files. During the inspection we spoke with a number of staff including, the registered manager, the learning disability manager, two care coordinators, the regional trainer and five carers.
Updated
14 July 2017
The inspection took place on the 16, 17 and 18 May 2017 and was announced.
Carewatch (Crewe) provides personal care and support services to people in their own homes. The agency is registered to provide services to older people, older people with dementia and adults who may have learning or physical disabilities, mental health problems or sensory impairment. Their offices are based in Crewe.
At the time of our inspection, the service was supporting nine people in four 'supported living' properties. Supported living describes the arrangement whereby people are supported to live independently with their own tenancies. In addition to supported living, the service also provides personal care to people in their own homes. There were 59 people in receipt of personal care. This was our first inspection since the location had registered with us.
There was a registered manager in place. 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.
We found that overall people were positive about the service they received. Some people were very complimentary and told us that they felt safe and well supported. We found that staff understood their responsibilities to report safeguarding concerns and to protect people from abuse or harm. Staff had received appropriate training and knew how to report concerns appropriately.
We found some shortfalls in the safe administration of medicines because systems in place to record medication administration were not always followed. We saw that the registered manager had already identified some of these issues and was taking action to make improvements. We received confirmation following the inspection that staff had subsequently completed medication training.
There were sufficient staff to meet the needs of people receiving a service. The service had recruited new staff. People told us that staff usually arrived on time and calls were not missed. The service had a call monitoring system to support the monitoring of calls. However some people reported issues with the consistency of staff and the registered manager was taking steps to address people’s concerns about this.
We found that staff were appropriately skilled and trained to meet people’s needs effectively. We found that staff completed an induction prior to starting work in the service. Staff received regular and on-going training. However the service needed to ensure that all staff had the appropriate knowledge to enable them to meet individual needs.
People told us that staff were caring. We found that people and their relatives were happy with the support they received and told us that staff treated them with dignity and respect. Staff demonstrated a good understanding of the importance of treating people with dignity. However we received some comments which indicated that new staff were not always introduced to people before providing personal care.
Care support plans and risk assessments were in place. However we found in some cases that risk assessments needed to be more tailored to peoples’ individual needs. Care support plans provided detailed information and were regularly reviewed and updated. They included information about people’s preferences and choices. People were supported to maintain as much independence as possible. The service was flexible and responsive.
People had access to the complaints procedure and told us that they knew how to make a complaint should they need to. We found that the management team had contact with people and dealt with any issues and concerns as they arose.
The management team were friendly and approachable. We found that information was organised and readily available. There were systems in place to monitor the support provided and people's views and opinions were sought regularly about the quality of the service. Staff told us that they felt well supported by the management team. Actions had been taken to make improvements to the organisation and quality of the service. There were plans in place to develop and improve the service further.