21 June 2018
During a routine inspection
Not everyone using Carewatch (Isle of Wight) received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
This inspection was conducted between 21 and 29 June 2018 and was announced. We gave the provider 48 hours' notice of our inspection as we needed to be sure key staff members would be available. At the time of the inspection approximately 128 people were receiving a regulated activity from Carewatch (Isle of Wight).
We last inspected the service in April 2017 when we did not identify any breaches of regulation, but rated the service as ‘Requires improvement’. Following that inspection, the registered manager wrote to us detailing the improvements they planned to make.
At this inspection, we found improvements had been made, but some further improvement was needed to ensure risks to people were consistently managed effectively. We found a key staff member was not aware of a serious risk to a person with a serious medical condition and there was a lack information in the care plan of another person who experienced epileptic seizures.
There were enough staff available to attend all calls. However, some people felt the timings of visits was not always consistent and the provider was unable to confirm the level or extent of late calls. We have made a recommendation about this.
Appropriate recruitment procedures were in place to help ensure that only suitable staff were employed.
Where staff supported people to take their medicines, we found this was done in a safe way. Staff followed infection control procedures and used personal protective equipment when needed.
Staff understood their safeguarding responsibilities and knew how to identify, prevent and report abuse. The registered manager reported incidents appropriately to the local safeguarding authority and cooperated fully with any investigation.
There was a plan in place to deal with foreseeable emergencies and staff had been trained to administer basic life support.
People were complementary about the competence of staff and the quality of care they received. New staff completed an effective induction into their role and experienced staff received regular refresher training in all key subjects. Staff were appropriately supported in their role by managers.
Staff followed legislation to protect people’s rights and sought consent before providing care or support to people.
Senior staff conducted assessments of people’s needs before agreeing a package of care. Care plans were informative, up to date and reviewed regularly.
People received personalised care from staff who understood their individual needs well. Staff were flexible and adaptable when people’s needs or wishes changed.
Where staff were responsible for preparing meals, they encouraged people to maintain a healthy, balanced diet based on their individual needs and preferences.
Staff monitored people’s health and supported them to access healthcare services where needed.
Staff were caring and compassionate. They built positive relationships with people, encouraged them to be as independent as possible and involved them in decisions about their care.
Staff treated people with dignity and respect and protected their privacy during personal care.
Staff knew how to support people to receive a comfortable, dignified and pain-free death and some had received specialised training in end of life care.
People had confidence in the service and felt it was managed effectively. They knew how to raise a complaint and felt they would be listened to.
There was a clear management structure in place. Most staff were motivated and happy in their work. They were aware of the provider’s ethos and how they were expected to work.
There was an effective quality assurance process in place at the service, with appropriate oversight by the provider. The provider sought and acted on feedback from people. Arrangements were in place to share lessons learnt from incidents and inspections and to promote best practice.
There was an open and transparent culture. The registered manager notified CQC of all significant events and policies were in place to encourage staff to raise concerns.