22 March 2016
During a routine inspection
Carewatch (Hampshire South) provides care to people living in their own homes across various locations in and around the Hampshire area. The number of hours provided to people had significantly reduced since our last inspection. The provider’s documentation showed the Chandlers Ford office was commissioned to provide 2,977 care hours per week compared to 4,260 per week when we inspected in September 2015.
At our announced inspection on 14, 15 and 16 September 2015, the provider was in breach of nine regulations relating to; person-centred care, dignity and respect, need for consent, safe care and treatment, safeguarding service users from abuse, meeting people’s nutritional and hydration needs, receiving and acting on complaints, good governance and staffing.
We took action and issued warning notices against the provider in relation to staffing and good governance. We told the provider they must meet the requirements of these notices by 14 March 2016. We rated the service ‘Inadequate’ and it was therefore placed in 'Special measures'. The provider sent us an action plan to tell us how they would meet the requirements of the warning notices and how they would meet the other regulations.
We undertook an announced comprehensive inspection on 22, 23 and 24 March 2016 to check they had followed their plan and met the legal requirements in relation to the warning notices we issued and the other breaches. At this inspection we found significant improvements had been made. The provider had met the warning notices, however improvements were still needed to be made with some of the other regulations requiring improvement. The rating for Carewatch (Hamsphire South) has been changed from ‘Inadequate’ in every domain to ‘Requires Improvement’ in every domain and therefore the service will be taken out of special measures, though improvements will need to be sustained.
Significant progress had been made in respect of the number of suitably skilled, qualified and experienced staff deployed. However the provider still required improvements to ensure all care visits were delivered.
Significant progress had been made in respect of staff training and induction. However the provider still required improvement to ensure all staff were appropriately trained to meet people’s individual needs.
Significant progress had been made in relation to staff supervision and appraisal. However the provider still required improvement to ensure all staff are given the opportunity to discuss their learning objectives and to meet formally with their manager.
Progress had been made in how the provider checked staff were of suitable character to care for vulnerable people. Improvements were still required to ensure the provider’s recruitment processes were robust.
The provider was aware of who required assistance with their medicines and medication administration records were now in place. However the provider required improvement to ensure reasons for the administration of some medicines such as paracetamol, were always recorded.
People told us they were treated with dignity and respect when they received care. However improvements were required to ensure people’s queries about their care were responded to in a timely manner.
Improvements had been made in how staff applied the Mental Capacity Act 2005. Although progress was slow in this area it was clear the provider had working plans in place to ensure people’s choices were respected and that decisions were made in people’s best interest.
Improvements had been made in how people were supported to reduce the possibility of becoming malnourished or dehydrated. Records in people’s homes provided staff with guidance on how to encourage people to eat and drink.
People’s care records were personalised and reflected their actual needs and preferences. Care plans had been recently reviewed and updated with the involvement of the person receiving care and their family member where possible.
The culture within the service had dramatically improved and staff felt supported by their manager. People, relatives and healthcare professionals all told us the leadership was honest and willing to learn from mistakes made in the past.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.