Archived: Carewatch (Wirral)

Updated 16 October 2018

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.

This inspection took place on 11, 12 and 23 July 2018, the first day was unannounced.

The inspection was carried out by two adult social care inspectors and two experts-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.

Inspection site visit activity started on 11 July and ended on 23 July 2018. It included speaking with thirty people who used the service by telephone and visiting 5 people in their homes with their permission. We also spoke with fifteen relatives of people who used the service.

We visited the office location on 11 and 12 July to see the manager and office staff; and to review care records and policies and procedures. We also spoke with nine other members of staff. This included the quality support manager, 3 quality officers and 5 care staff.

We looked at care records for ten people who used the service and the staff files for six members of staff. We also looked at records showing how the service was managed including quality audits and feedback the registered manager had received from people who used the service and their families.

Before the inspection, the registered manager completed a Provider Information Return (PIR). This is a form that asks for 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 spoke with the quality assurance team from the local authority. We used this information to plan our inspection.

Updated 16 October 2018

This inspection took place on 11, 12 and 23 July 2018. The first day of the inspection was unannounced. On the 23 July 2018 we made arrangements to visit people who used the services of Carewatch Wirral.

At the time of our inspection Carewatch Wirral provided support for 178 people who were living in their own homes. For 116 people they provide the regulated activity of personal care.

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 2008 and associated Regulations about how the service is run.

During our previous inspection in August 2016 there were breaches of Regulations 16 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating of the service was ‘requires improvement’. This is because complaints made about the service were not always recorded and responded to. Complaints were not reviewed to work out potential problems and assess the quality of the service provided to people. Also, important information about people and their care was not fed back to the people organising the care at the office. At times information was fed back but not recorded effectively so that it could be used to inform staff providing people’s care.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions. Is the service safe? Is the service responsive? And; Is the service well-led? To at least good. At this inspection we found that the service was no longer in breach of regulations and the overall rating is now good.

At this inspection we looked at the records of complaints at the service and saw that the service kept records of complaints made, investigations that had taken place and responses that had been made to people who had raised the complaint. If the service had fallen short of acceptable standards the response to a complaint included an apology and an explanation of what actions are being taken to correct the problem. We also saw that complaints had been responded to in a timely manner.

We also saw that appropriate procedures were being followed to ensure that the administration of medication was safe. We saw that there was a clear record of the medication prescribed to people and what had been administered by staff members. This was documented in medication administration records (MAR) and in people’s daily care records. Staff received medication training and competency assessments, to check that they administered people’s medication safely.

Previously, there was a lack of systems that would enable the manager to assess the quality and safety of the care being provided to people. At this inspection we saw that improvements had been made in how the safety and quality of the service was assessed. Although we made some recommendations on how further improvements can be made the service was no longer in breach of this regulation.

The way the service was delivered ensured that it was extremely reliable, which is very important for people living in their own homes relying on support to meet their needs. We spoke to 35 people and 15 relatives of people who use the service. They all told us they felt safe with the support that they or their family member received.

People told us that the staff provided good care and were caring towards them. People described the staff using words such as, “sensational”, “amazing”, “upbeat”, “compassionate” and “happy”. One person told us, “They are precious to me, I call them my family.”

Staff were positive about their role in providing care for people. New staff had a thorough induction programme which ensured they were equipped to support people effectively. All staff received regular refresher training in areas the provider viewed as mandatory. This ensured that staff were always up to date with current practice in their work.

People were supported with any healthcare needs that arose. Staff were vigilant in spotting when people were unwell and took appropriate action.

People received support that was appropriate to their need and preferences as outlined in their care plan. People’s care plans had been written and agreed with the person and if appropriate their family members. There was sufficient detail in the plans to highlight to care staff what care the person needed, their preferences and what the person had agreed to.

The service was working within the principles of the MCA. People’s consent to their care was sought and people were supported to make decisions for themselves. We saw that if they were able to people had signed to say that they consented to their care plan.

The registered manager had a Quality Improvement Plan (QIP) in place and was working on areas of the service to improve its quality. They had a clear vision of how to provide person centred support that was effective in helping people. People we spoke with and their relatives told us they felt there was now clear lines of communication with the managers and the office.

The registered manager was very engaging with all staff members. There was a warm and friendly atmosphere in the office; and when we made visits to people who had agreed to meet us, the registered manager was friendly and it was clear that they had positive relationships with the people who used the service.