Archived: Carewatch (Bentley Grange)

Updated 24 September 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 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.

We visited the two locations on the 13 and 20 August 2018. We conducted telephone interviews to gain important feedback on the 22 August 2018 from people and health and social care professionals.

This was an unannounced inspection to follow up on the concerns we found at our last inspection where the overall rating was Inadequate and the service placed into special measures. The inspection team consisted of two inspectors.

Before our inspection we reviewed all the information we held about the service. This included the action plans that the provider had submitted to meet the breaches of regulation, statement of purpose and registration documents. As this was an inspection that was following enforcement action, a PIR had not been requested. This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make.

We considered information which had been shared with us by the Local Authority and looked at safeguarding alerts that had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. We contacted the Local Authority to obtain their views about the care provided by the service.

During the inspection, we spoke with 12 people from both locations, the registered manager, the deputy manager at Cranbrook, eight care staff and six relatives. We talked with people in the communal areas and by invitation in their flats.

We reviewed the records of the service, which included quality assurance audits, staff training schedules and policies and procedures. We looked at nine care plans and the risk assessments included within these, medicine administration records for those who were supported with medicines by care staff along with other relevant documentation to support our findings. We also ‘pathway tracked’ nine people. This meant we followed a person’s life and the provision of care through the service and obtained their views. It was an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

Updated 24 September 2018

We inspected Carewatch (Bentley Grange) on the 13, 20 and 22 August 2018. The first day of which was unannounced which meant they did not know we were coming. The further days were arranged so as to meet and talk with people who received care and support from Carewatch services at both locations.

Carewatch (Bentley Grange) is a domiciliary care agency (DCA). This service provides care and support to people living in extra care housing in a purpose built block of flats so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Carewatch (Bentley Grange) is situated in Hailsham, East Sussex and has a satellite location, Cranbrook, which is situated in Eastbourne, East Sussex. They provide personal care for people living in extra care housing in a purpose-built block of flats. Extra care housing is designed for people who need some help to look after themselves, but not at the level provided by a residential care home. People living in extra care housing have their own accommodation and have care staff that are available when needed. The people supported by the service had a wide range of needs including dementia, care needs related to age and people who live with a learning disability. There were 69 people being supported at this time.

At our comprehensive inspection in December 2017 and January 2018, the service was rated inadequate and placed into special measures. This was because we found five breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014. These related to the delivery of safe care, including medicine management, receiving and acting on complaints, consent to care provided, staff deployment and good governance. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Carewatch (Bentley Grange) on our website at www.cqc.org.uk.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

Following that inspection, the provider sent us an action plan on how they would meet these regulations. At this inspection we found the provider had made the required improvement and now complied with our regulations. The service has now been taken out of special measures. We have rated the service overall as Requires Improvement. This is because of the previous rating of inadequate in the safe and well-led questions. We needed to be sure they were delivering consistent safe care and were well managed before we can change the rating of safe and well-led to Good.

The last inspection report separated the two locations, Cranbrook and Bentley Grange, as the services had very different outcomes for people. As there had been significant improvements made at Cranbrook we have reported as one service.

There was a registered manager in post who was also the registered provider. 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 felt safe with their care staff. Staff understood the importance of keeping people safe and knew the action to take if they had any suspicions that someone was at risk of harm. Risks to people within their home environment and out in the community had been assessed and where issues were identified action was taken to mitigate the risk of harm. People were protected by the prevention and control of infection. Staff understood their responsibilities to report safety incidents, and improvements were made when things went wrong. There were enough staff to meet people’s assessed needs. People were provided with consistency and continuity of care, with a small staff team that knew them well. Safe recruitment practices were followed to reduce the risk of unsafe staff working with people. Staff were trained and supported to have the skills and knowledge to meet people’s needs. Staff enjoyed their role and felt valued by the registered manager. People that received support with their medicines did so safely. Staff had been trained in medicine administration and regular checks were made to ensure people were receiving their medicines safely.

People’s needs were assessed before staff began to support them. The assessments took into account peoples protected characteristics such as their ethnicity and religious beliefs. Where staff were responsible, people were supported to eat and drink enough to maintain a balanced diet. Referrals and advice was sought from relevant health care professionals to ensure people remained as healthy as possible. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were asked for their consent prior to any care or support tasks being completed. The registered manager had taken the necessary steps to ensure that people only received lawful care that was in line with legislation.

Staff treated people with kindness and respect, whilst maintaining people’s privacy and dignity. People were regularly asked for their views about the service and be actively involved in their care. Staff understood the importance of maintaining people’s confidential information. The systems in place supported the management of confidential personal information, in line with legislation.

People and their loved ones were encouraged and supported to raise any issues or concerns with the registered manager. There was a formal complaints procedure in place, and details of how to complain were held with the person’s care records at their home. People were supported by staff to attend functions within their community and in the wider community.

The registered manager had made the necessary arrangements to ensure that regulatory requirements were met. People that were supported by the DCA, their relatives and members of staff were actively engaged in developing the service. Systems were in place to monitor and improve the quality of the service that was provided to people. The registered manager and the staff team actively worked in partnership with other agencies to support the development of joined-up care.