Carewest Ltd

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Carewatch (Lancashire West & Central) is registered to provide support with personal care. At the time of our inspection visit there were 87 people who received support.

Not everyone using Carewatch (Lancashire West & Central) receives 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 consider any wider social care provided.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered managers, 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.

At the last inspection in March 2018, we found two breaches of regulation. We found breaches in the regulations related to safe care and treatment and good governance. We issued requirement notices for these breaches in regulation. In addition to the requirement notices we made a recommendation related to people's capacity to consent to care.

Following the inspection in March 2018, we asked the registered manager to act to make improvements in the areas we had identified. The registered manager was required to send the CQC an action plan, outlining how they intended to make improvements. We used this inspection process carried out in January 2019 to check the action plan had been followed and improvements made.

At this inspection, we found improvements had been made. Staff had the skills, knowledge and experience required to support people with their care and support needs.

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 documentation in the service supported this practice.

People's care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered. Care plans held personalised information that guided staff on peoples support needs and promoted positive relationships.

Care records contained information about the individual's ongoing care and rehabilitation requirements. This showed us the registered manager worked alongside other health care services to meet people's health needs.

The service had systems to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs. New staff shadowed experienced staff members while they learnt their role.

The registered manager completed spot checks on staff to observe their work practices were appropriate and people were safe.

The registered manager planned visits to allow carers enough time to reach people and complete all tasks required. People told us they mostly had the same staff visit and relationships had developed.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

The service had safe infection control procedures and staff had received infection control training. Staff had been provided with protective clothing such as gloves and aprons as required. This reduced the risk of cross infection.

Staff supported people to have a nutritious dietary and fluid intake. Assistance was provided in preparation of food and drinks as people needed.

People told us staff were caring. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.

The service had information with regards to support from an external advocate should this be required by people they supported.

People told us staff who visited them treated them with respect and dignity. People's end of life decisions were documented within their care plans.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The service had kept a record of complaints received and these had been responded to appropriately.

The service used a variety of methods to assess and monitor the quality of the service. These included quality monitoring, quality assurance visits and care reviews.

The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.

The five questions we ask about services and what we found