Archived: Carewatch (Brighton)

Updated 7 July 2015

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. We last visited the service on 27 June 2013 and we found the service met the regulations we inspected.

This inspection took place on 16 and 20 March 2015 and was announced. We told the manager five days before our inspection that we would be coming. This was because we wanted to make sure that the manager and other appropriate staff were available to speak with us on the day of our inspection. One inspector undertook the inspection, with an expert-by-experience, who had experience of older people’s care services. 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 helped us with the telephone calls to get feedback from people being supported.

Before the inspection, we reviewed information we held about the service. This included previous inspection reports, complaints and any notifications. A notification is information about important events which the service is required to send us by law. Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also sent out questionnaires to a sample of people using the service, care staff and community professionals. Feedback from these were used in this report. This enabled us to ensure we were addressing potential areas of concern.

We telephoned two local authority commissioning teams, who have responsibility for monitoring the quality and safety of the service provided to local authority funded people. We contacted a health care professional and two care managers from the local authority commissioning team to ask them about their experiences of the service provided.

During the inspection we went to the agency’s office and spoke with the manager, two field supervisors, a co-ordinator and the company trainer. In addition to this we spoke with six care staff over the telephone following the inspection, 15 people using the service, five relatives and a private carer. We spent time reviewing the records of the service, including policies and procedures, six people’s care and support plans, the recruitment records for four new care staff, complaints recording, accident/incident and safeguarding recording, and staff rotas. We also looked at the provider’s quality assurance audits.

Updated 7 July 2015

This inspection took place on 16 and 20 March 2015 and was announced.

Carewatch (Brighton) is a domiciliary care agency and provides personal care and support for adults living in their own home in the Brighton and Hove area and West Sussex. Care was provided predominantly to older people, including people with a physical disability, learning disability, sensory loss, mental health problems or people living with dementia. At the time of our inspection around 317 people were receiving a service.

On the day of our inspection, there was no registered manager in post. A new manager had been recruited and was present during the inspection. However, a registered manager application had not been received by the Care Quality Commission (CQC). 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.

Systems were in place to audit and quality assure the care provided. People were able to give their feedback or make suggestions on how to improve the service, through the reviews of their care. However,reviews were behind in being completed.

The times that care staff arrived to support people did not always enable people to have the agreed support provided. For example, take their medicines at the right time.

There were clear policies in place to protect people from abuse, and staff had a clear understanding of what to do if safeguarding concerns were identified. However, not all care staff had been following the agreed procedures when shopping for people to fully protect people from financial abuse.

When new care staff were employed safe recruitment practices were in place to be followed, however agreed procedures had not been followed in all instances.

People and their relatives told us that they or their relative were safe with the staff that supported them. Detailed risk assessments were in place to ensure people were safe within their own home and when they received care and support.

Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.

People told us they were involved in the planning and review of their care. Where people were unable to do this, the manager told us they would liaise with health and social care professionals to consider the person’s capacity under the Mental Capacity Act 2005. Care staff had a good understanding of the need for people to consent to their care and treatment.

Care staff received an induction, basic training and additional specialist training in areas such as caring for people living with dementia. Care staff had supervision in one to one meetings, spot checks and staff meetings, in order for them to discuss their role and share any information or concerns.

The needs and choices of people had been clearly documented in their care plans. Where people’s needs changed, people’s care and support plans were reviewed to ensure the person received the care and treatment they required.

People and their relatives told us they were supported by kind and caring staff. Care staff were able to tell us about the people they supported, for example their likes and dislikes and their interests. People told us they always got their care visit, that they were happy with the care and the care staff that supported them.

People were consulted with about the care provided. They knew how to raise concerns or complaints.

The manager, along with senior staff provided good leadership and support to the care staff. They were involved in day to day monitoring of the standards of care and support that were provided to people using the service.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond to breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of this report.