Background to this inspection
Updated
4 June 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Clearwater Care group provides care and support to people living in eight ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was on long term leave at the time of our inspection.
Notice of inspection:
We gave the service 48 hours’ notice of the inspection visit because it is small and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 9 April 2019 and ended on 29 April 2019. We visited the office location on 9 April 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service from the provider since the last inspection. We sought feedback from the local authority and professionals who work with the service. This information helps support our inspections.
During the inspection
We spoke with four people who used the service, two relatives, and one person’s representative, about their experience of the care provided. A further relative sent us their feedback on the service in an email. We spoke with nine members of staff including the group supported living manager, three team leaders, one senior support worker, three support workers and the registered manager of another service who was supporting this service. We received feedback from four external health and / or social care professionals who shared their views about the service provided with us.
We reviewed a range of records. This included sampling six people’s care records, three staff files in relation to recruitment and staff training records. We also reviewed a variety of records relating to the management of the service. These included accident and incident reports, complaints, meeting minutes and audits.
Updated
4 June 2019
About the service:
Clearwater Care Group is a domiciliary care agency that provides personal care and support to people with learning disabilities and one older person. At the time of our inspection the service provided personal care to 11 people living in their own homes, some of which were houses of multiple-occupancy in Peterborough, Worcestershire and Staffordshire. The size of the properties meets current best practice guidance. This promotes people living in a small domestic style property to enable them to have the opportunity of living a full life. The service’s office was in Peterborough.
Not everyone using Clearwater Care Group receives regulated activity; CQC 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 consider any wider social care provided.
The principles and values of Registering the Right Support and other best practice guidance ensure people with a learning disability and or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People’s experience of using this service:
Staff did not always follow the provider’s policy to make sure they only employed staff once they were satisfied of their suitability to work with people who used the service. There were enough staff to meet people’s needs safely. Managers reviewed staffing levels and people needs regularly. Staff worked well together to ensure people were safe and well cared for. They knew the people they cared for well and understood, and met, their needs.
People were protected from avoidable harm by a staff team trained and confident to recognise and report any concerns. Staff assessed and minimised any potential risks to people. Staff followed the provider’s procedures to prevent the spread of infection and reduce the risk of cross contamination. The provider had systems in place to enable staff to safely manage people’s medicines.
People received care from staff who were trained and supported to meet people’s assessed needs. Staff supported people to have enough to eat and drink and maintain a healthy weight. They worked well with external professionals to support people to keep well.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were involved in making decisions about their care and support. Where people needed additional support to make decisions, staff had referred people to external advocates.
Staff supported people in a sensitive and friendly way. One person told us, “You can have a good banter with the staff here. They’re the best staff you could wish for. They are down to earth.” Staff were respectful when they spoke with, and about, people. They supported people to develop their independence.
Support was person centred and met each person’s specific needs. People and their relatives were involved in their, or their family member's, care reviews. People’s care plans were in the process of being completely revised to ensure they were up-to-date, and more individualised. People’s needs were constantly reviewed, and support adapted as required. Staff encouraged and enabled people to be as active as possible and pursue their interests. People and their families felt able to raise concerns which the provider addressed. The provider had systems in place, including a complaints procedure, to deal with any concerns or complaints.
Four companies had merged in the last 12 months, leading to positive changes in the way people’s care and support was managed. The provider promoted a culture that focused on people as individuals. The provider had put robust systems in place to effectively monitor the service and bring about further improvement.
Rating at last inspection:
At the last inspection we gave the service a rating of good (published 12 October 2016).
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
More information is in the detailed findings below.