Carewatch (Isle of Wight) is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It is registered to provide a service to older adults, younger adults and children.

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 sta

Carewatch (Isle of Wight) provides domiciliary care services to people living at home. They currently provide a total of 2005 hours of personal care to 170 people. Each person received a variety of care hours from the agency, depending on their level of need.

The inspection was conducted between 20 and 27 April 2017 and was announced. We gave the provider 48 hours’ notice of our inspection as it was a domiciliary care service and we needed to be sure key staff members would be available.

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 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.

Staff did not always have access to adequate guidance to help ensure individual risks to one person were managed appropriately. However, people told us staff knew how to protect them from harm and staff took action to keep people safe.

Where people required assistance to take their medicines, these were usually managed and administered appropriately. However, there was a lack of information to support staff to administer one person’s ‘as required’ medicines safely.

Senior staff responsible for planning people’s care did not always follow legislation designed to protect people’s rights, although care staff did seek verbal consent from people before providing care and support.

There was a quality assurance process in place to assess and monitor the service, although this had not always been effective in identifying improvements that were needed.

There were enough staff to attend all care visits and meet people’s needs. Appropriate recruitment processes were in place to help ensure only suitable staff were employed.

People praised the quality of service they received. They were supported by staff who were suitably skilled and supported appropriately in their role.

Staff were caring, kind and compassionate. They knew people well and built positive relationships with them. They encouraged people to remain as independent as possible and involved them in decisions about their care.

Staff respected people’s privacy and dignity at all times. They also took care to be as discreet and unobtrusive as possible when working in people’s homes.

Where staff were responsible for preparing meals, they encouraged people to maintain a healthy, balanced diet. They also supported people to access healthcare services when needed.

Staff were led by people’s wishes and empowered people to make choices. They provided personalised care and responded promptly when people’s needs changed.

The provider sought and acted on feedback from people and there was an appropriate quality assurance process in place.

People, their relatives and staff felt the service was organised and run well. Staff were motivated and happy in their work and understood the expectations of the service.

The culture of the service was open and transparent. The registered manager notified CQC of all significant events. They responded positively and promptly to address issues raised during the inspection.