Background to this inspection
Updated
8 November 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 comprehensive inspection was carried out by one inspector and an 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 made telephone calls to people prior to the office visit.
The office visit took place on 11 October 2017 and was announced. The provider was given 48 hours’ notice that we were coming so they could arrange to be there.
Before our inspection visit we asked the provider to complete a Provider’s Information Return (PIR). This document allows the provider to give us key information about the service, what it does well and what improvements they plan to make. We were able to review the information as part of our evidence during the inspection. We found the information contained in the PIR reflected the service provided.
Prior to the office visit we reviewed the information we held about the service. We looked at the statutory notifications the service had sent us. A statutory notification is information about important events which the provider is required to send to us by law. We contacted the local authority commissioners to find out their views of the service provided. Commissioners are people who contract care and support services paid for by the local authority. They were aware of the concerns we had referred to them and had no other information to share with us. We also reviewed the ‘Share your experience’ information people had sent us since the last inspection.
The provider was asked to send a list of people who used the service. This was so we could send surveys to people and contact people by phone to ask them their views of the service. Surveys were sent to 24 people who used the service, 24 relatives and two professionals. Surveys were returned from 10 people who used the service and six relatives. We spoke with 19 people by phone, 12 people who used the service and seven relatives or friends. We used this information to help us make a judgement about the service.
During our visit to the agency office we spoke with, the provider, the registered manager, the care manager, the team mentor, a care co-ordinator and four care staff. We reviewed five people’s care records to see how their care and support was planned and delivered. We looked at four staff recruitment files, staff training records, records of complaints and compliments, and records associated with the provider's quality monitoring systems.
Updated
8 November 2017
Carewatch Coventry is a domiciliary care agency registered to provide personal care to people living in their own home. At the time of our inspection visit the service provided personal care to 42 people.
The office visit took place on 11 October 2017 and was announced. We told the provider 48 hours before the visit we were coming so they could arrange to be there and arrange for staff to be available to talk with us about the service.
A requirement of the provider’s registration is that they have 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. There was a registered manager for the service at the time of our inspection.
Prior to our inspection visit we received concerns from three relatives about the care and support provided to their family members. These were about inconsistent care staff and the time they visited. People we contacted during our inspection reported similar concerns. We reviewed people’s concerns during our inspection.
There were enough staff to provide the care and support people required. However, people had different experiences in the punctuality and continuity of care staff. Some people said they received care from staff they knew well and who arrived around the time expected. Others had experienced late and missed calls and their regular care staff had been changed. The provider and managers were aware of people’s concerns and had taken action to ensure people were allocated regular care staff who arrived around the time expected. All the people we spoke with said care staff stayed long enough to provide the care they required.
The provider and registered manager told us, the disruption to the service people had received during the summer months was due to an unprecedented amount of staff sickness and the recent expansion of the service. They assured us this had been resolved.
People said they felt safe using the service and staff understood how to keep people safe from abuse. There were processes to minimise risks to people’s safety. These included procedures to manage identified risks with people’s care and for managing people’s medicines safely. The suitability of staff was checked during recruitment procedures to make sure they were safe to work with people who used the service.
The managers and staff followed the principles of the Mental Capacity Act (MCA). Staff respected decisions people made about their care and gained people’s consent before they provided personal care.
Staff received an induction when they started working for the service and completed training to support them in meeting people’s needs effectively. Most people said staff had the right skills to provide the care they required. People told us they received care from staff that were friendly and caring, and who treated them with dignity and respect.
Care staff understood people’s needs and preferences, as they had time to talk with people and read their care plans. Care plans and staff work schedules provided guidance for staff about people’s care needs and instructions of what they needed to do on each visit.
Staff felt supported to do their work effectively and said the managers were approachable and knowledgeable. There was an ‘out of hours’ on call system, which ensured management support and advice was always available for staff.
People knew how to complain and information about making a complaint was available for people. People and staff knew they could raise any concerns or issues with the management team, although some people told us they did not always feel listened to.
The provider’s quality monitoring system included asking people for their views about the quality of the service. This was through telephone conversations, visits to review people’s care and satisfaction questionnaires. There was a programme of other checks and audits which the provider used to monitor and improve the service.
The management team checked people received the care they needed by reviewing people’s care records when they were returned to the office and through feedback from people and staff.
Following our feedback to the provider and registered manager about people’s experiences of inconsistency in their service, the managers’ contacted people to discuss their care service to make sure this had improved. People said it had.