Archived: Carewatch (Wirral)

At the time of our inspection Carewatch Wirral provided support for 178 people who were living in their own homes. For 116 people they provide the regulated activity of personal care.

The service had 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.

During our previous inspection in August 2016 there were breaches of Regulations 16 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating of the service was ‘requires improvement’. This is because complaints made about the service were not always recorded and responded to. Complaints were not reviewed to work out potential problems and assess the quality of the service provided to people. Also, important information about people and their care was not fed back to the people organising the care at the office. At times information was fed back but not recorded effectively so that it could be used to inform staff providing people’s care.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions. Is the service safe? Is the service responsive? And; Is the service well-led? To at least good. At this inspection we found that the service was no longer in breach of regulations and the overall rating is now good.

At this inspection we looked at the records of complaints at the service and saw that the service kept records of complaints made, investigations that had taken place and responses that had been made to people who had raised the complaint. If the service had fallen short of acceptable standards the response to a complaint included an apology and an explanation of what actions are being taken to correct the problem. We also saw that complaints had been responded to in a timely manner.

We also saw that appropriate procedures were being followed to ensure that the administration of medication was safe. We saw that there was a clear record of the medication prescribed to people and what had been administered by staff members. This was documented in medication administration records (MAR) and in people’s daily care records. Staff received medication training and competency assessments, to check that they administered people’s medication safely.

Previously, there was a lack of systems that would enable the manager to assess the quality and safety of the care being provided to people. At this inspection we saw that improvements had been made in how the safety and quality of the service was assessed. Although we made some recommendations on how further improvements can be made the service was no longer in breach of this regulation.

The way the service was delivered ensured that it was extremely reliable, which is very important for people living in their own homes relying on support to meet their needs. We spoke to 35 people and 15 relatives of people who use the service. They all told us they felt safe with the support that they or their family member received.

People told us that the staff provided good care and were caring towards them. People described the staff using words such as, “sensational”, “amazing”, “upbeat”, “compassionate” and “happy”. One person told us, “They are precious to me, I call them my family.”

Staff were positive about their role in providing care for people. New staff had a thorough induction programme which ensured they were equipped to support people effectively. All staff received regular refresher training in areas the provider viewed as mandatory. This ensured that staff were always up to date with current practice in their work.

People were supported with any healthcare needs that arose. Staff were vigilant in spotting when people were unwell and took appropriate action.

People received support that was appropriate to their need and preferences as outlined in their care plan. People’s care plans had been written and agreed with the person and if appropriate their family members. There was sufficient detail in the plans to highlight to care staff what care the person needed, their preferences and what the person had agreed to.

The service was working within the principles of the MCA. People’s consent to their care was sought and people were supported to make decisions for themselves. We saw that if they were able to people had signed to say that they consented to their care plan.

The registered manager had a Quality Improvement Plan (QIP) in place and was working on areas of the service to improve its quality. They had a clear vision of how to provide person centred support that was effective in helping people. People we spoke with and their relatives told us they felt there was now clear lines of communication with the managers and the office.

The registered manager was very engaging with all staff members. There was a warm and friendly atmosphere in the office; and when we made visits to people who had agreed to meet us, the registered manager was friendly and it was clear that they had positive relationships with the people who used the service.

At the time of our inspection there was a new manager in place. The manager was not registered with the Care Quality Commission; however they had started the process of registration.

We found breaches relating to complaints and lack of good governance. You can see what action we told the provider to take at the back of the full version of the report.

Information regarding complaints was either not recorded or was recorded in a way that didn’t allow the manager to collect information, acknowledge the complaints and respond to them. There was no reviewing of complaints in order to assess potential problems and the quality of the service provided for people.

Information was not being used effectively. We saw occasions when important information regarding people and their care was not fed back to the office. We also saw occasions when information was fed back to the office and it had been recorded, but not effectively or in an appropriate place.

The systems for sharing important information were not working. The quality assurance systems had not picked up on this. Quality assurance visits to people’s homes and reviews of people’s care had not picked up on out of date, incorrect or incomplete information in people’s care files. People’s complaints and feedback. Differences in people’s medication, MAR errors and incidents.

Some people’s care plans were not being followed or did not have up to date information in them. Information was not always fed into them by the systems in place. At times the care plans did not provide enough information or guidance for care staff. The lack of information in place could have an impact on people’s health and wellbeing.

The majority of the feedback from people was positive and people told us they were happy with their care. We saw and people told us of examples when care staff had gone above and beyond what people expected of them. Other people told us that the quality of the care they received varied from carer to carer. Some people told us they received care from familiar staff, others said staff varied a lot.

People told us they were treated with dignity and respect. We saw and were told that there were many positive relations between carers and the people they cared for. The office had received thank you cards and on one day we visited a bouquet of flowers.

The office received many phone calls and we saw that these were dealt with in a friendly manner and efficiently. When problems arose with people’s visits staff were proactive with providing people with information and offering solutions.

We saw the system Carewatch Wirral had in place to ensure that no visits to people’s homes were missed. Almost 100% of visits had an allocated carer on a roster system that was sent to each carers phone. Carers logged into and out of each call giving the office up to date information on the visits people were receiving. People told us Carewatch Wirral never missed a call. We saw that there were adequate numbers of staff to fulfil people’s care needs.

Staff received a thorough induction which they praised. We saw that systems were in place to support staff members including training and periodic training refreshers, supervision meetings, in work assessments, staff meetings and annual appraisals. There was a senior member of staff available on-call 24hours a day. Staff received training in safeguarding vulnerable adults.

We saw that the language and descriptions of people used in people’s care plans were respectful and sensitive to people’s dignity. We found that the organisation operated within the principles of the Mental Capacity Act (2005), people’s consent was sought for their care.

Some of the systems in the office worked effectively. Rosters and information relating to staff was clear and up to date. Training was up to date and in line with the organisations schedule. The manager had in place a ‘service quality improvement plan’ which outlined the performance of the organisation against key targets.