Archived: Carewatch (Bourke Gardens)

Updated 12 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is 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 on 17 and 22 May 2018. The first day was unannounced, however we informed staff we would be returning for a second day to complete the inspection and announced this in advance. Both days of the inspection were carried out by an adult social care inspector from the CQC. A pharmacist inspector from CQC attended on the second day of the inspection to look at how medication was handled.

Prior to the inspection we reviewed all of the information we held about the service in the form of notifications, expected/unexpected deaths and safeguarding incidents. We contacted Salford city council before our inspection to establish if they had any information to share with us. This would indicate if there were any particular areas to focus on during the inspection.

During the inspection we spoke with a wide range of people and viewed a range of records and documentation. This included speaking with the registered manager, regional operations director, the team leader, five people who used the service, five care staff and two visiting health care professionals.

Records looked at included six care plans, five staff personnel files, 12 Medication Administration Records (MAR), training records, and any relevant quality assurance documentation. This helped inform our inspection judgements.

Updated 12 July 2018

We carried out this inspection of Carewatch Bourke Gardens on 17 and 22 May 2018. The first day was unannounced, however we informed the registered manager we would be returning for a second day to complete the inspection.

Carewatch Bourke Gardens is a domiciliary care service based in Worsley, Salford. The service is located across the road from Walkden shopping precinct and has good access to local transport networks in the area and across Greater Manchester.

The service is made up of 57 apartments, some of which accommodate up to two people and at the time of the inspection there were 62 people living at Bourke Gardens. Only 36 of these people were receiving a regulated activity which was personal care. We only focussed on the care provided to these people during the inspection.

Carewatch Bourke Gardens is a ‘Domiciliary Care Service’. People live in their own apartments within an extra care housing scheme which are owned and operated by the housing provider, City West. Staff are on site 24 hours a day and people can receive between one and four calls a day to receive personal care or additional assistance to promote their independence. As the housing provider is not registered with CQC, we do not regulate the building and this area was not covered during the inspection.

This was the first inspection we had carried out at Carewatch Bourke Gardens, since registering with CQC in January 2017.

During this inspection we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regards to safe care and treatment, safeguarding people from abuse and improper treatment and good governance (two parts of the regulation). You can see what action we have asked the service to take at the end of the full version of this report.

Risks to people who used the service were not always being effectively mitigated and appropriate risk assessments had not consistently been completed to help keep people safe.

Accurate and contemporaneous records were not always being maintained regarding people’s care which meant we could not always determine if safe care and treatment was being provided.

Appropriate systems were not always in place to ensure people were not being deprived of their liberty unlawfully. Deprivation of Liberty Safeguards (DoLS) do not apply in this type of service, however this means applications need to be made to the court of protection to ensure people are not being unlawfully deprived of their liberty.

Each person living at Carewatch Bourke Gardens had their own care plan in place. We found several examples where important aspects of people’s care was not documented within their care plan meaning staff did not have access to up to date information.

Improvements were required to the overall governance systems to ensure concerns identified during this inspection were identified internally and acted upon in a timely manner.

People living at Carewatch Bourke Gardens told us they felt safe and was one of the main benefits of living at the service compared to living in an independed tenancy with no support.

In advance of the inspection we received several notifications from the service about medication errors which had occurred at Carewatch Bourke Gardens. Medication was therefore reviewed by a CQC pharmacist and the administration of people’s medication was found to be safe.

Staff were recruited safely with appropriate checks carried out when staff commenced employment.

Staff displayed a good understanding about how to report potential safeguarding concerns and had completed training in this area.

Staff received the appropriate induction, training, supervision and appraisal to support them in their role.

The service had an onsite kitchen which was operated by City West (The housing provider). People were provided one meal a day which was included as part of their care package and there was the option of additional meals to be paid for by the person. People told us the food available was of good quality.

We saw other health professionals were involved in people’s care and we observed health care professionals visiting the service during the inspection.

People living at Carewatch Bourke Gardens told us they were happy with the care and support they received. People said they felt treated with dignity and respect and could lead independent lives, but received support from staff if they needed it.

Complaints were investigated and responded to appropriately and compliments about the service had been collated.

Activities within the service were operated by the housing provider and people told us there was enough going on to keep them occupied.

Team meetings took place within the service so that staff could discuss their work and report any concerns. Competency assessments were undertaken for each member of staff, covering areas such as medication.

Policies and procedures were in place which provided advice and guidance about all aspects of service delivery.

Appropriate notifications were sent to CQC about incidents such as medication errors and safeguarding concerns.