Background to this inspection
Updated
20 February 2016
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.
The inspection was carried out by one adult social care inspector and one 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. The expert by experience who took part in this inspection had experience of domiciliary care.
Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are submitted to the Care Quality Commission and tell us about important events which the provider is required to send us. We spoke with the local authority to gain their feedback about the care people received. This helped us to gain a balanced overview of what people experienced accessing the service. At the time of our inspection there were no safeguarding concerns being investigated by the local authority.
We visited three people who received support in their home and looked at their care plan and medicine records. We spoke with eight people and five relatives via the telephone. We spoke with the registered manager and 12 staff members. We reviewed six people’s care files, eight staff files, the staff training matrix and a selection of policies and procedures. We reviewed records related to the management and safety of the service.
We looked at what quality audit tools and data management systems the provider had in place. We reviewed past and present staff rotas focussing on how staff provided care within a geographical area. We looked at how many visits a staff member was completing per day. We looked at the continuity of support people received.
Updated
20 February 2016
The inspection visit at Carewatch (North Lancashire) was undertaken on 05 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service to people living in the community. We needed to be sure someone would be in at the office.
Carewatch (North Lancashire) provides personal care and support to people living in their own homes. The agency covers a wide range of dependency needs including older people with a physical or learning disability and older people living with dementia or mental health problems. The agency's office is located close to Morecambe town centre. At the time of our inspection there were 253 people receiving a service from Carewatch (North Lancashire).
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.
At the last inspection on 21 November 2013, we found the provider was meeting the requirements of the regulations that were inspected.
Staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure. One person told us they always felt they were in safe hands, because of the continuity of staff. They said, “I’ve got to have trust and I trust them.”
The provider had put in place procedures around recruitment and selection to minimise the risk of inappropriate employees working with vulnerable people. Required checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.
We found staffing levels were suitable with an appropriate skill mix to meet the needs of people who used the service. Staffing levels were determined by the number of people being supported and their individual needs.
Staff responsible for assisting people with their medicines had received training to ensure they were competent and had the skills required. People were supported to meet their care planned requirements in relation to medicines.
Staff members received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. The provider ensured staff had the skills to fulfil all care tasks required by people being supported. For example, the registered manager had sought specialised training to ensure staff delivered effective support to one person with complex care needs.
People and their representatives told us they were involved in their care and had discussed and consented to their care packages. We found staff had an understanding of the Mental Capacity Act 2005 (MCA).
People told us they were mostly supported by the same group of staff. This ensured staff understood the support needs of people they visited and how individuals wanted their care to be delivered. One person we spoke with said, “I don’t like change. I like the same team because they are in my life. They have been brilliant.”
Comments we received demonstrated people were satisfied with the service they received. The registered manager and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people in their care. Field care supervisors’ met with people prior to care being delivered. This allowed personalised care plans to be in place before care staff visited. Field care supervisors are not office based and oversee the care staff deliver within the local community setting.
A complaints procedure was available and people we spoke with said they knew how to complain. We saw examples where a complaint had been received, responded to, investigated and the outcome documented. Staff spoken with felt the management team were accessible supportive and approachable and would listen and act on concerns raised.
The registered manager had sought feedback from people receiving support .They had formally consulted with people they supported for input on how the service could continually improve. Quality audits had regularly been used at the time of our inspection. Surveys, telephone monitoring and spot checks had all regularly taken place. They had not always acted on the feedback they received. Meetings for care staff had occurred when management had introduced new policies or procedures. Regular team meetings for staff to meet with the manager, to share information, learn and receive feedback had not occurred.