This inspection took place on 8 April 2015 and was announced. Carewatch (Lincoln) provides personal care in people’s homes to adults of all ages with a range of health care needs. There were approximately 250 people using the service at the time of the inspection.
At the time of our inspection the service did not have a registered manager. The provider was in the process of making an application to the Care Quality Commission for a registered manager. 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 our inspection on 21 July 2014, we asked the provider to take action to make improvements to their staffing levels. Following that inspection the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we looked to see if these improvements had been made and found these actions had been taken and improvements to staffing numbers made.
We also asked the provider to take action to make improvements to their quality monitoring system, however the action taken has not resulted in improvements to the service which people receive. During this inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was a lack of systems in place to ensure that people received their care in a timely and consistent manner. People had raised issues about this but the provider had failed to resolve these. You can see what action we told the provider to take at the back of the full version of this report.
People said they felt safe with the care they received. Staff had completed safeguarding training and had access to guidance. They were able to recognise if people were at risk and knew what action they should take. The provider had taken action when people had been identified as at risk and learning had taken place.
People had risk assessments. Where risks had been identified there were plans to manage them effectively. Staff understood risks to people and followed guidance. Staff were alert to changes in people’s usual presentation. They recorded incidents and reported them.
There was usually sufficient staff to provide people’s care however the staff providing care to people was not always consistent and available when people required care. Recruitment checks ensured that people were protected from the risk of being cared for by unsuitable staff.
People’s care was provided by staff who were sufficiently trained and supported. Staff undertook medicines training and had a medicines competency check. Staff had received an induction when they started employment with the provider and completed further training relevant to people’s needs and were supported to undertake professional qualifications. Systems were in place to support staff and monitor their work.
Where people lacked the capacity to consent to their care relevant guidance had been followed. The provider was aware of anyone who was legally appointed to make decisions for people. People told us staff treated them with dignity and respect. People’s needs in relation to nutrition and hydration were documented. People did not always receive appropriate support to ensure they received sufficient to eat at an appropriate time. Care plans were personalised and people were supported to maintain their choices. However care plans were not always consistently updated.
There had been a change in the leadership of the location in the past six months. Staff felt supported by the new leadership and the registered manager ensured people had information and support to make complaints. Where complaints were made they were investigated and actions taken in response however although individual complaints were addressed the provider did not have systems in place to learn from these or to address the underlying issues.
The majority of people told us there were good communications from the office and they knew who to speak with. People’s feedback on the service was sought through telephone calls, surveys and visits. Staff were encouraged to speak with the office about any concerns they had about people’s care.