Archived: Carewatch (Reading and West Berkshire)

Carewatch (Reading & West Berkshire) is a domiciliary care agency. It provides personal care to people living in their own homes. It currently provides a regulated activity to approximately 100 people with various needs.

At the last inspection on 2 May 2017, we asked the provider to take action to make improvements with the safety recruitment practices, and this action has been completed.

There was a manager running the service who had almost completed the registration process. 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.

People and staff were protected from harm and were kept as safe as possible. Staff had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff knew how to protect the people in their care and understood what action they needed to take if they identified any concerns. General risks and risks to individuals were identified and action was taken to reduce them, as far as possible. People were supported to take their medicines safely (if they needed support in this area) and medicines given were recorded accurately. People were supported by care staff whose values and attitudes had been tested and who had been safely recruited.

People’s needs were met safely and effectively because there were enough staff who were given enough time to meet their identified needs. People were assisted by care staff who had been trained and supported to make sure they could meet people’s varied needs. Care staff were effective in addressing people’s needs as described in their care plans. The service worked closely with health and other professionals to ensure they were able to meet any specific health or social care needs.

People were assisted to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

A caring, kind and committed staff team provide people with compassionate care. Care staff built close relationships with people and knew their preferences and requirements. The management team and care staff were aware of people’s equality and diversity needs which were noted on care plans. People were encouraged to be as independent as possible.

People benefitted from a flexible service that responded quickly to individuals' current and changing needs and preferences. People’s needs were reviewed regularly to ensure the care provided was up-to-date. Care plans included information to ensure people’s individual communication needs were understood.

The manager was described as very supportive, passionate and caring. The manager and the staff team were committed to embracing diversity and did not tolerate any form of discrimination. The service assessed, reviewed and improved the quality of care provided.

At our last inspection on 19 January 2016 we found that the service required improvement in three areas including keeping people safe, providing an effective service and being responsive. We undertook this comprehensive inspection to check on the progress of any improvements and to make a judgement about the overall compliance of the service. We found the service had made the necessary improvements highlighted at the previous inspection. However, we found that there were deficits with safe recruitment practices where improvements needed to be made.

Carewatch Care Services Limited is a care agency which provides staff to support people in their own homes. People with various care needs can use this service including people with physical disabilities, mental health needs and older people. At the time of this inspection 140 people received care from this service.

The service had 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.

People and their relatives told us that they felt safe with staff and would be confident to raise any concerns they had. The provider’s recruitment procedures were thorough, however, we found that processes were not always adhered to according to regulations or the providers own procedure and there was no registered manager oversight of the practice. Medicines were managed safely. There were sufficient staff to provide safe, effective care at the times agreed by the people who were using the service. You can see what action we told the provider to take at the back of the full version of the report.

People were supported to have choice and control of their lives, in relation to their care package, and support was provided to them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were procedures in place to manage risks to people and staff. Staff were aware of how to deal with emergency situations and knew how to keep people safe by reporting concerns promptly through processes that they understood.

Staff received an induction and spent time working with experienced members of staff before working alone with people. Staff were supported to receive the training and development they needed to care for and support people’s individual needs.

The majority of people and their families spoke positively and were complimentary of the services provided. The comments we received demonstrated that the vast majority of people felt valued and listened to. People were treated with kindness and respect whilst their independence was promoted within their homes and the community. People received care and support from familiar and regular staff most of the time and some would recommend the service to other people.

People’s needs were reviewed and their care and support plans promoted person-centred care. Up to date information was generally communicated to the staff to ensure they could provide the appropriate care and support for each individual. Staff knew how to contact healthcare professionals in a timely manner if there were concerns about a person’s wellbeing.

The provider had a system to regularly assess and monitor the quality of service that people received and identified areas for improvement.

Carewatch (Reading and Berkshire) provides support and personal care to people in their own homes. At the timeof our inspection approximately 160 people were receiving personal care and support from this service.

The service had 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.

Most aspects of safe recruitment practices, such as police identity and character checks, were in place. However, the provider had failed to gather full employment history of their prospective staff members. As a result, people were not properly protected from the risk of being supported by unsuitable staff. The identified gaps in employment history had not been fully examined and explained.

At this inspection we found that arrangements were in place to monitor staff attendance at work and to minimise the number of missed calls. However, staff had not always been available to attend a call and to provide care to people at the agreed time. There had been two recent missed calls identified by the arrangements introduced by the manager.

People told us they felt safe and well cared for. Staff were aware of how to raise any concerns. Having received training on safeguarding adults, staff knew the signs of possible abuse. Possible risks to people were identified and plans were put into place to reduce those risks. Arrangements had been made to deal with emergencies, and staff had received first aid and fire safety training.

Staff were caring and positive relationships had developed between them and people. Staff understood the Mental Capacity Act 2005. Following the principles of that act, they always remembered to ask people for permission before providing support to them. Staff members treated people with respect and helped them maintain their dignity. People were encouraged and supported by staff to make their own decisions and choices.

The staff training matrix was up to date and one-to-one supervision meetings took place to support staff in carrying out their roles effectively. However, the relatives of people were not confident that staff had the skills and knowledge to deliver care to a good standard.

People who use the service told us that staff were caring, treated them with kindness and politeness, respected their privacy and encouraged their independence. Staff were able to describe what actions they took to maintain people’s privacy and independence. They also had a good understanding of people’s individual support needs.

The various nutritional needs of people were met by the service where appropriate. People told us they were given a choice of what they preferred to eat. Depending on the individual, staff either prepared meals or supported people who were able to prepare meals for themselves.

People knew how to make a complaint, and the service had a complaints procedure in place. People told us they were not always involved in the process of planning and reviewing their care.

Staff told us the service was well-led and both the branch manager and the registered manager were approachable and supportive.

The registered manager had implemented a number of changes to the way in which the service had been run, and this appeared to have improved the overall quality of the service. Nonetheless, the ways of ensuring the quality of care were not sufficiently effective and the required records were not always maintained or available.