Archived: Carewatch (Bristol)

Updated 6 February 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.

This inspection took place on Friday 14 November 2014 and Monday 17 November 2014 and was unannounced. The inspection was carried out by two inspectors.

At the last inspection on 5 August 2015 the service was not meeting the regulations. These were relating to the care and welfare of people, lack of staff support and concerns about the monitoring of the quality of the service

During our inspection we went to the location office and spoke to the acting manager, the compliance manager and six members of staff. We looked at six people’s care records, the records for six staff, and records relating to the management of the service. These included staff training and induction records, five people’s medicines records and quality assurance information.

We visited two people who used the service and one person’s relative in their own home. After the inspection visit we undertook phone calls to 11 people who used the service.

Updated 6 February 2015

The inspection took place on 14 and 17 November 2014 and was unannounced. At our inspection in August 2013 we identified breaches of regulations relating to care and welfare, how staff were supported and how the quality of the service was managed.

During this inspection we looked at whether improvements had been made. We found that improvements still needed to be made in relation to care and welfare, supporting staff and how the quality of the service was managed.

Carewatch (Bristol) provides personal care to people in their own homes and support with household tasks such as cleaning and shopping. At the time of our visit there were around 70 people using the service.

The inspection took place on 14 and 17 November 2014 and was unannounced. At our inspection in August 2013 we identified breaches of regulations relating to care and welfare, how staff were supported and how the quality of the service was managed.

During this inspection we looked at whether improvements had been made. We found that improvements still needed to be made in relation to care and welfare, supporting staff and how the quality of the service was managed.

Carewatch (Bristol) provides personal care to people in their own homes and support with household tasks such as cleaning and shopping. At the time of our visit there were around 70 people using the service.

There was no registered manager and there had not been one for over 18 months. 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. There was an acting manager who was appointed to the post in August 2014.

The registered provider, who is also the nominated individual, was unable to fulfil the requirements of their role for personal reasons.

Although people said they felt safe we found that the agency was not providing consistently safe care. People regularly did not receive their planned visits from care staff at the required times and on some occasions not receiving visits at all. This directly impacted on the safety and welfare of a number of people who used the service.

People had an individual plan setting out the support they needed and how this was to be provided. Some people’s support was not provided as detailed in their care plans. Some people’s needs had not been regularly reviewed. This meant people did not always receive support in a way that met their needs. For example one person told us their morning visits frequently took place so late their relative had to stay in bed and could not get up at the time of their choosing.

People told us the care workers treated them with kindness and respect. Staff had got to know many of the people they supported well. They also demonstrated an understanding of the needs of people they regularly visited. However staff and people who used the service told us there were often times when they had to assist people who they did not know or only knew slightly. This impacted on the ability of staff to provide a personalised service to people.

The provider had a system in place to ensure safe and suitable staff were recruited. New staff completed training before working unsupervised for the agency. The staff understood their responsibility to protect people from potential harm or abuse. They knew what action to take if they were concerned about the safety of a person using the service.

There had been an increase in late visits and missed visits to people by care workers over the previous six months for a significant number of people. The online monitoring system known as CM2000, which is a system put in place by the Local Authority recorded there were recent and regular occasions when some people were not receiving a safe service.

The lack of reliability of the service people received meant it was not fully effective as people’s personal care needs were not always met.

People reported a lack of effective communications from the office and the staff there. People told us they were often not given the information they asked for if a care worker was running late for a visit. Some people also told us they were rarely contacted with an explanation for why a visit was late or missed. The majority of people said they were given unhelpful responses, such as being asked to remember there were people who were much sicker than they were. One person also reported how they were often called “love” or “darling” when they rang the office, and they found this patronising.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to the number of staff, a lack of staff supervision and monitoring the quality of the service. You can see what action we told the provider to take at the back of the full version of this report.