We inspected Carewatch (Swindon) on 13 November 2018 and the inspection was announced. This service is a domiciliary care agency (DCA). It provides personal care to people living in the community. People include older adults, some living with dementia, disabilities and sensory impairments. Not everyone using the service receives regulated activity; Care Quality Commission only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. On the day of the inspection the service was supporting 57 people. At the last inspection, the service was rated Requires Improvement. We found the provider did not always maintain an accurate, complete and contemporaneous record. We also found the provider’s quality assurances processes and systems to assess, monitor and mitigate risks were effective and fit for purpose. These issues were a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued a requirement notice and asked the provider to send us an action plan on how they were going to address these concerns. We received an action plan promptly that stated the provider was going to be compliant by June 2018.
At this inspection we found the service improved to Good, however their quality assurance processes around monitoring people’s visits needed to be more proactive.
There was 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.
People told us they felt safe receiving care from the team. Staff were trained in safeguarding and understood their responsibilities to report any concerns. Medicines were managed safely. There were sufficient staff deployed to keep people safe and the provider followed safe recruitment processes. The registered manager worked to improve the risks assessments and risks to people's well-being, individual conditions and environment were recorded and reviewed regularly.
The registered manager and the team promoted a positive and transparent culture. The service worked with a number of external professionals including local social and health professionals. Staff told us they were well supported by the registered manager.
People’s needs were assessed to ensure the team were able to care for them effectively. People’s rights to make their own decisions were respected. Staff received training relevant to their roles and told us they were supported by their managers. People were supported to access health services and maintain their dietary needs.
The team provided support in a caring way. People told us they built caring relationships with staff. Staff treated people with dignity and respect. People were involved in their care and encouraged to be independent as much as possible. There were processes in place to ensure people’s confidentiality.
The registered manager worked to improve the care planning documentation and planned further improvement to make the records more user friendly. People told us they were supported by staff that knew them and the support provided met their needs. People knew how to make a complain and complaints received were recorded and dealt with in line with the provider’s policy. Where people received palliative support, the service worked with external professionals and people’s relatives to ensure appropriate care was provided.