5 July 2017
During a routine inspection
Carewatch (Wigan) are a large domiciliary care service providing care and support to people with a range of differing needs within their own home. The service is managed from an office in Standish and is a member of the local authorities ‘Ethical Community Services Framework’, being awarded the contract for provision of care in Pemberton and Wigan Central. At the time of the inspection 443 people were using the service.
At the time of the inspection there was a registered manger in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 using the service and their relatives told us they felt safe as a result of the care and support provided by Carewatch (Wigan). We saw the service had appropriate safeguarding policies and procedures in place. Staff had all received training in safeguarding vulnerable adults, which was refreshed annually and were able to demonstrate a good understanding of how to report both safeguarding and whistleblowing concerns. Staff were confident any concerns raised would be actioned by senior staff.
Both people using the service and staff members we spoke with felt enough staff were employed to meet people’s needs. People spoke positively about the continuity of care and stated that overall staff arrived on time and stayed as long as was needed to provide the care required. Staff felt their rota was manageable and in most instances appropriate travel time had been factored in. The service used systems to ensure staffing levels were appropriate to meet people needs and calls were logged and monitored electronically to ensure consistency.
We saw there was both a policy and systems in place to ensure safe medicines management was maintained. People we spoke with confirmed they received appropriate support to ensure medicines were taken when required and as prescribed. We saw the service carried out audits of a selection of medicine administration record (MAR) charts each month to ensure medicines had been administered and documentation completed correctly. All staff administering medicines had received training and had their competency assessed.
We saw that robust recruitment procedures were in place to ensure staff working for the service met the required standards. This involved all staff having a Disclosure and Baring Service (DBS) check, at least two references and full work history documented.
Staff were complimentary about both induction and refresher training and confirmed they received an appropriate level of training to carry out their role effectively. We saw all staff completed a comprehensive induction training programme followed by a variable period of time shadowing experienced care staff, before being allowed to work independently with people who used the service. We saw the service had systems in place to ensure that staff received regular refresher training to ensure their skills and knowledge remained up to date.
People we spoke with told us the staff were kind and caring and treated them with dignity and respect. People had been involved in discussing their care and how they wanted to be supported, with clear guidance in place within care files to ensure staff knew how to meet their needs and wishes. Staff were knowledgeable about the importance of promoting people’s independence and how to go about doing so.
We looked at 16 care plans, which were comprehensive and person centred containing detailed information about each person. The care plans also contained risk assessments, which helped to ensure people’s safety was maintained. We saw a process was in place for reviewing care plans, which was done both in person and via telephone calls and people were also asked for their opinions of the service and care received through completion of bi-monthly questionnaires.
People using the service knew how to complain, with information provided in the care files they kept in their homes. People we spoke with who had raised a complaint reported these had been dealt with quickly and effectively. The service had a robust complaints policies and procedures in place, with all issues and outcomes documented in detail.
Each staff member we spoke with said they enjoyed their job and felt the service was well run. The completion of regular supervision and team meetings, meant they felt supported in their roles and had the opportunity to discuss issues relevant to them.
We saw that there were a range of systems and procedures in place to monitor the quality of the service. Audits were carried out both internally by the registered manager and quality performance officers and externally by the provider and their representatives. A quality improvement plan was in place to ensure any issues or areas of non-compliance were being addressed. We saw this was updated regularly to reflect progress made.