Background to this inspection
Updated
7 May 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 was planned to check 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.
The inspection took place between 5 December 2014 and 6 February 2015 and was announced.
The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
The inspection was carried out by an Adult Social Care inspector and an expert-by-experience. 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 inspector visited the agency office on 5 December 2014 and 6 February 2015 and looked at care records for 6 people who used the service, training records for 5 staff and recruitment records for 2 staff. We also looked at records relating to complaints were managed and how the provider checked the quality of the service provided. We spoke with fifteen people who use the service and 4 relatives on the telephone and visited 3 people in their own homes. We also spoke with the manager of the service and 6 care staff.
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 reviewed the information we held about the service, including the information in the PIR, before we visited the service. We also contacted the local authority commissioning and social work teams for their views of the service.
Updated
7 May 2015
This announced inspection took place on 5 December 2014 and 6 February 2015. We last inspected this service in December 2013. At that inspection we found that the provider was meeting all of the regulations that we assessed.
Carewatch (South Cumbria) is a domiciliary care agency based in Kendal. The agency provides personal care and support to people who live in the south of Cumbria. It provides care to people in their own homes, including people who need support due to physical needs, mental health needs, people who live with dementia and people who have a learning disability. There were 70 people receiving support from the service when we carried out our inspection.
There was no registered manager at the service. 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.
People were not safe using this service because risks were not managed effectively. Some risk assessments were not fully completed and others held inaccurate information. This meant that the care staff did not have accurate information about how to protect people from harm.
The service was not well managed and the systems used to assess the quality of the service were not effective. Although the provider had carried out their own checks on the service and had identified areas which required improvement, action had not been taken to address the issues found.
People could not be confident that their rights were protected because the Mental Capacity Act 2005 Code of practice had not been followed when people were not able to make their own decisions about their care. The provider did not have robust systems in place to ensure that decisions about people’s care were made by those who had the legal right to do so or that they were made in the individual’s best interests.
Care records were not always completed fully and did not include guidance for staff on how to support people who had complex needs. This meant people did not always receive the support they required.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to the rights of people living with dementia not being protected, care not being planned and delivered to ensure people received the support they needed and not monitoring the quality of service well enough. These corresponded to breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We also found a breach of the Care Quality Commission (Registration) Regulations 2009 because the provider did not have a registered manager in place at the service.
You can see what action we told the provider to take at the back of the full version of the report.
People received care from a small group of staff who they knew and who helped them to remain safe in their homes. Checks were carried out on new staff to ensure they were safe and suitable to work in people’s homes.
The care staff treated people with kindness and respect. People valued the relationships that they had with the staff who supported them.
People were asked for their views about the service. The provider had formal and informal systems to gather the views of people who used the service.
People knew how they could complain about the service they received and were confident that action would be taken in response to any concerns they raised.