Background to this inspection
Updated
18 May 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The 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.
This inspection took place on 9 December 2014 and was announced. We gave the provider 48 hours’ notice of the inspection because it was a domiciliary care service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
The inspection was carried out by an inspector and an expert by experience who completed telephone interviews to ask people, and their relatives, what they thought of the service provided by Carewatch (Meridian). An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
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. It asks what the service does well and what improvements it intends to make. We reviewed the Provider Information Record (PIR) before the inspection. We also looked at our own records such as any notifications of incidents which occurred and records regarding safeguarding investigations. A notification is information about important events which the provider is required to tell us about by law.
We looked at care records for 17 people and spoke to 15 people and to two relatives, to ask them their views about the service they received. We also sent survey questionnaires to people and relatives to ask them for their views on the service. Twenty one surveys were returned to us from people and six from relatives.
We looked at the records of five staff including staff recruitment, training, induction and supervision records. We spoke to four staff, the registered manager and the deputy manager. Survey questionnaires were sent to 11 staff and were returned by three. We also accompanied a member of staff on visits to two people who received personal care from Carewatch (Meridian). We spoke with these people, observed some of the care they received and spoke with the staff member who was supporting them. Records of complaints, staff rosters, satisfaction surveys, and policies and procedures were reviewed.
We contacted social services staff who commissioned services from Carewatch (Meridian) to ask for their views on the service and to the local authority safeguarding team.
This was the first inspection of this service since their registration in September 2013.
Updated
18 May 2015
Carewatch (Meridian) provides personal care to people in their own homes. At the time of the inspection the service provided care to 97 people with a range of needs including those living with dementia and people who needed support following hospital in-patient treatment.
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 and associated Regulations about how the service is run.
People, and their relatives, said they felt safe with the staff. There were policies and procedures regarding the safeguarding of adults. Staff had a good awareness of the correct procedures to follow if they considered someone they provided care to was being neglected or poorly treated.
Staffing was organised so people received a reliable service. We did, however, received some feedback from people where staff did not always arrive on time. For those people we spoke to about this they told us this was sometimes due to unforeseen delays and that they were informed of this.
People were supported by staff to take their medicines and this was recorded in their care plans. Staff were trained and their competency assessed regarding the support they gave to people with medicines.
Checks were carried out on newly appointed staff so that people received care from staff suitable to work with them. People were supported by staff who were well trained and motivated to provide a good standard of care.
People had agreed and consented to their care. There were policies and procedures for the use of the Mental Capacity Act 2005 (MCA). Staff had a good understanding of the principles of the legislation and knew what to do when someone did not have capacity to consent to their care.
People’s nutritional needs were assessed and they were supported with meals and drinks. Arrangements were made to support people with their healthcare needs, such as liaising with community health services and monitoring people’s general health.
People were treated with kindness and respect. People described staff as “gentle,” kind and thoughtful. People were consulted about how they liked to be supported so care was provided in the way they preferred.
People said they were involved in reviews of their care needs and their care was adjusted and amended to suit their changing needs and preferences. Issues raised by people were addressed such as requests for changes in care times and care staff. People said staff carried out additional tasks if they asked them.
There was an effective complaints procedure. People said they knew how to raise any issues they had about their care and that these were addressed to their satisfaction. Complaints were investigated and responded to by the registered manager.
The provider used a number of methods to monitor its performance and to check people received the right care. These included people being asked if they were satisfied with their care. Checks were made that staff behaviour and performance promoted a caring and effective service. Staff were committed to providing a good service and knew what to do if they had any concerns about people’s welfare and safety. Systems were used by the service’s management team to monitor that care was reviewed with people on a regular basis. Plans were put in place where quality assurance checks showed improvements were needed to the service.