This inspection took place over a number of days and these included 10, 11, 12, 17, 18, 25 and 26 July 2017.

Carewatch Southend provides personal care and support to adults who live in their own homes in the geographical areas of Rochford, Rayleigh, Castle Point, Basildon and surrounding areas. It is a large service and provides care and support to over 800 people and employs over 250 staff.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manager 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.

Systems were in place to assist people with the management of their medication and help ensure people received their medication as prescribed. However, we did find that people had sometimes received their medication too close together due to times of visits and that one prescription tablet did not always have sufficient time allocated for administration. Action was taken to rectify this straight away.

There were generally sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service, but some people had experienced late or early calls which did not always meet their needs. The provider was very proactive at dealing with these types of concerns and we had confidence that people’s visit times would be addressed as a matter of priority.

Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

Where needed people were supported to eat and drink sufficient amounts to help meet their nutritional needs and staff knew who to speak with if they had any concerns around people’s nutrition. People were supported by staff to maintain good healthcare and were assisted to gain access to a range of healthcare providers, such as their GP, dentists, chiropodists and opticians.

People had agreed to their care and asked how they would like this to be provided. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner. Assessments had been carried out and care plans had where possible been developed around each individual’s needs and preferences.

The registered manager had a good understanding of the Mental Capacity Act and mental capacity assessments had been completed with additional assessments requested from the appropriate government body where people were not able to make significant decisions for themselves.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service had an effective quality assurance system and had regular contact with people who used the service. People felt listened to and that their views and opinions had been sought, as a result improvements had been made through learning from people’s views and opinions.

Many of the people spoken with had been receiving a service from Carewatch Southend for a number of years. They said they had been part of the assessment and care plan process and their choices had been taken into consideration. They added that they had been able to make decisions about their care and how they wanted this to be provided.

People using the service told us that they had had contact with management and that they were able to express their views about the service. They had been made aware of the complaints procedure and confirmed they had received written documentation during the assessment.

There were systems and procedures in place to help staff identify concerns and respond appropriately to the signs and allegations of abuse. Those spoken with added that they felt safe with the staff and that they considered they were well trained.

People we spoke with were complimentary about the service and made positive comments. Comments taken from the provider’s quality assurance included, “Her positive attitude and kind consideration gave my father and the family confidence in a situation very new to us,” “They are very caring and kind,” “Thank you for your help, kindness and support,” and “We would like to say what wonderful professional and very caring person ‘X’ is, and to thank her and all the other caring and very kind ladies.”

The people with whom we spoke were positive about the care and service they received from Carewatch Southend. They all confirmed they had been involved in the assessment process and their care needs had been discussed with them. They had also been involved in decisions on how they wanted their care provided. Those who were receiving assistance with personal care confirmed that staff ensured their privacy and dignity was upheld. Comments received on the agency’s 2011 quality evaluation report included “They treat me very well”, “I'm impressed”, “Quite happy”, “Kind staff”, “They are very good”, “First-class, “The care is very good” and “Very pleasant.”

People with whom we spoke did not raise any concerns about the care they received from the staff. They were positive about the staff working for the agency and these comments have been reflected throughout the report. People knew who to speak to if they were unhappy.

This inspection took place over a number of days and these included 15, 18, 22 and 25 June 2015.

Carewatch Southend provides personal care and support to adults who live in their own homes in the geographical areas of Southend, Rochford, Rayleigh, Castle Point, Basildon and surrounding areas. It is a large service and employs over 250 staff.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manager 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 showed a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe. Systems were in place to assist people with the management of their medication and help ensure people received their medication as prescribed.

Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

There were generally sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service.

Where needed people were supported to eat and drink sufficient amounts to help meet their nutritional needs and staff knew who to speak with if they had any concerns around people’s nutrition. People were supported by staff to maintain good healthcare and were assisted to gain access to a range of healthcare providers, such as their GP, dentists, chiropodists and opticians.

People had agreed to their care and asked how they would like this to be provided. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner. Assessments had been carried out and care plans had where possible been developed around each individual’s needs and preferences.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and are required to report on what we find. The MCA sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The DoLS are a code of practice to supplement the main MCA code of practice. The registered manager had a good understanding of MCA and DoLS and mental capacity assessments had been requested from the appropriate government body where people were not able to make decisions for themselves.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service had an effective quality assurance system and had regular contact with people who used the service. People felt listened to and that their views and opinions had been sought. The quality assurance system was effective and improvements had been made as a result of learning from people’s views and opinions.