The inspection took place on 7 March 2017. People who used the service were contacted by telephone on 8 and 9 March 2017. The inspection was announced. This was because the service provides care to people in their own homes and we needed to be sure that someone would be available in the office to support our inspection.

The service was last inspected in November 2014 and was rated as good.

The service provides personal care to 128 people in their own homes.

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.

Feedback from people using the service was positive. People told us they felt safe and well cared for. People received safe support with their medicines.

There were sufficient numbers of staff to ensure people’s safety and to cover unplanned staff absences. People were protected because staff were trained and confident in reporting safeguarding concerns.

Not all staff had received supervision in line with company policy however staff told us they felt well supported and well trained. Comments from people who used the service reflected they were satisfied with the skills and training of staff.

People reported feeling well cared for and had built positive relationships with the people that supported them. People were involved in reviewing their own care packages and were given opportunities to provide feedback on the service provided.

Care plans were person centred and in the main gave sufficient detail to guide staff in meeting their needs. We discussed with the registered manager how in some places further detail would be helpful. Staff told us that when they visited people they didn’t know, staff in the office gave them information about the person to enable them to provide the support they needed.

There was a system in place to monitor staff attendance at their planned calls. This involved filling in time sheets and returning them to the office. People reported no concern about missed calls.

Complaints were managed and responded to so that people could be confident about raising concerns or issues. One person gave a specific example of a concern they’d raised that had been dealt with well.

There were systems in place for monitoring the quality of the service provided, and these had identified most of the issues we found at the inspection.

People told us they were treated with dignity and respect. One person told us "all of the carers are very friendly". Another person told us "Our regular carer is like one of the family. The carer has been very helpful to us. She’s brilliant". People had an opportunity to be involved in the delivery of the service and provide feedback about the quality of the service they received.

There were comprehensive assessments of people's care needs ensuring the agency provided a service which met people's needs effectively. Records showed people received a consistent and responsive service.

There were appropriate arrangements for responding to any concerns about possible abuse. Staff had received the appropriate safeguarding training.

We found there were appropriate arrangements for the informal support of staff. However there was a failure to provide 1:1 supervision and yearly appraisals. Staff received the necessary training so they could undertake their role professionally and competently.

There were effective systems in place to review the quality of the service people received. The agency responded professionally to complaints. The agency took effective action to address any shortfalls in the quality of service people had received.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies.

The inspection team was led by a CQC inspector joined by an Expert by Experience, who has experience of using or caring for someone who uses this type of service.

We used telephone interviews and home visits to people who used the service and to their main carers (a relative or friends).

We visited four people in their homes. They told us that they were very happy with the care and support they received. We asked people about the way they were treated by staff when they visited. People told us they felt care workers were very polite and respectful, one person told us, “I have never had a problem, I know who is coming and they know what to do, I always feel they treat me with respect and are really nice”. Another person told us, “I quite look forward to the girls visiting me and they always have a smile”. One person said, “The care worker is like one of the family, reliable, on time, kind, very thorough, efficient and treats me with respect”.

We also spoke to 20 people over the telephone, people spoken with were very complimentary about the agency and about the way they were treated. We heard comments such as, “Treats me great, couldn’t be better”, and “Really lovely, they treat me with respect”. Another person told us “They will do any job that’s needed”. Two people told us that their regular care worker did everything for them but when they had someone standing in they were not as ‘vigilant’.

People told us they received the exact time they were paying for and that staff usually arrived on time. They also told us that they felt the care plans had been drawn up recognising their needs and not for the convenience of the agency.

Two people told us they were happy with the care they received but felt the office did not communicate well with them, one person said, “They say they will ring you back but they don’t”. We discussed this with the manager who confirmed they would raise the issue with the office staff. Another person said “the office always communicate any changes so I don’t get any surprises”.

This inspection took place on 14 and 17 November 2015. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a domiciliary care service. We wanted to make sure the registered manager would be available to support our inspection, or someone who could act on their behalf.

Carewatch (Bath & North East Somerset) is registered as a domiciliary care agency to provide personal care and support for people living in their own home. The agency provides services predominantly to older people, but also to adults with disabilities and long term illnesses. At the time of this inspection 184 people were using the service.

There is a registered manager in post at Carewatch (Bath & North East Somerset). 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. The registered manager was accessible and approachable. Staff, people who used the service and relatives felt able to speak with the registered manager to provide feedback about the service.

Staff were knowledgeable of people’s preferences and care needs. People told us the regular staff they had provided them with the care and support they needed and expected. However a few people commented negatively on the lack of consistency of staff sometimes.

People using the service, and the relatives we spoke with described the staff as being “caring”, “knowledgeable” and were “experienced.” Staff explained the importance of supporting people to make choices about their daily lives. Where necessary, staff contacted health and social care professionals for guidance and support.

Staff had received training in how to recognise and report abuse. All staff were clear about how to report any concerns they had. Staff were confident that any concerns raised would be fully investigated to ensure people were protected. However three out of the five staff we spoke with were less knowledgeable about the requirements of the Mental Capacity Act 2005. Staff said they “felt supported”, and they “received regular supervision.”

The registered manager had systems in place to monitor the quality of the service provided, and was working towards action plans where some shortfalls had been identified. Staff were aware of the organisation’s visions and values and spoke about being ‘valued and proud’ to work for Carewatch (BaNES).