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

We inspected Carewatch (Bentley Grange) on the 11, 15, 20 and 27 December 2017 and on the 5 and 8 January 2018. This was an unannounced inspection, which meant they did not know we were coming on the 11 December 2017. The further days were arranged so as to meet people who received care and support from Carewatch services at both locations.

Carewatch (Bentley Grange) is a domiciliary care agency. 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.

The service had a registered manager. 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 had responsibility for both Bentley Grange and Cranbrook.

This was the first inspection for Carewatch (Bentley Grange) since registering under the new provider in August 2017’. Cranbrook was found to be running as an unregistered service in August 2017, it was subsequently attached as a location to the registration of Bentley Grange in December 2017 to ensure it was legally registered.

There was a lack of leadership and oversight of the service. The registered manager of Bentley Grange had taken full responsibility for managing both locations and had not been supported by the provider to do so. At the beginning of the inspection it was clear that the two locations were running separately and that communication between the two was not clear or transparent. There was a registered manager based at Bentley Grange location and a manager based at Cranbrook. The manager at Cranbrook had applied to be registered with CQC.

The registered manager did not have oversight and information of the people who received care and support at Cranbrook.

Communication between the two locations improved considerably during the inspection. However, as discovered during this inspection process the acting manager of Cranbrook left the organisation in January 2018.

Cranbrook

Audits had been undertaken in September 2017 by senior managers of Carewatch where considerable shortfalls had been found in care documentation, care delivery and in management of medicines. Support had been given by the local authority and senior management of Carewatch. However the necessary improvements had not been taken forward and actioned in a timely manner.

People’s safety was put at risk, because risk assessments and risk management practices at the service were not consistent. Although the acting manager had considered some risks to people’s safety they did not ensure all risks had been properly assessed. The management of medicines were not always safe. Storage of medicines in peoples’ flats for those that lived with dementia were not always locked, placing people at risk of taking medicine without the required supervision. The provider had n