Caremark (Hillingdon)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were safely cared for and supported. There were systems to learn when things went wrong. Systems and processes to help protect people from abuse were operated effectively. Risks to people's safety and wellbeing had been assessed, planned for, and monitored. There were enough suitably trained staff to keep people safe and meet their needs. People received the right support with their medicines. We did not assess all the quality statements within this key question. We did not identify concerns relating to the areas which we judged as being met at our last inspection.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The staff told us they were invited to discuss when things went wrong and learn from these. The manager described some incidents to us. The explained how they had responded to these. The action they had taken included investigating what went wrong, creating plans to make improvements and sharing learning with staff.

The provider had systems for dealing with complaints, accidents, and incidents. There were records of all 'events' and details of how these had been responded to. The provider looked for any themes and took appropriate action to help prevent reoccurrences of incidents. Records showed that the provider had discussions with people using the service, families, and staff when things went wrong. They had updated care plans, risk assessments and guidance when needed.

People knew how to raise concerns and felt these had been addressed and responded to. The provider had apologised when things went wrong and involved people in making improvements to the service after this happened.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were policies and procedures regarding safeguarding and whistle blowing. The provider had worked with the local safeguarding authority and other agencies to help investigate allegations of abuse and put in place protection plans to help keep people safe.

People using the service and their relatives told us they felt safe. Their comments included, ''[Person] is safe and feels confident with the carers'', ''I can trust the carer 100%'' and ''I feel safe. We have had the same carer since 2017. We know each other well.''

The staff explained they had undertaken safeguarding training, so they knew how to recognise and report abuse. They understood when and how to speak up if they had concerns about abuse.

People using the service and their relatives told us the staff cared for them in a safe way, using appropriate techniques to help them move and when using equipment. The staff did not use any form of restraint or restrict people's freedom.

The staff told us they had undertaken a range of training including how to support people to move safely. Managers regularly assessed their skills and knowledge. Managers carried out spot checks to observe staff and make sure they were providing safe care.

The risks to people's safety and wellbeing had been assessed and planned for. Risk assessments were appropriately detailed. They included guidance on how to mitigate risks and information about people's individual needs. These had been regularly reviewed and updated.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were appropriate systems for recruiting staff. These included checks on their identity, knowledge, skills, attitude, and their right to work in the United Kingdom. New staff completed an induction which included training and observing how to provide good care. The management team assessed their skills, knowledge, and competencies as part of their induction. There were enough staff to meet people's needs. The provider did not agree to support new people if they did not have enough staff to support them. The provider used an electronic call monitoring system effectively to make sure care visits took place at the right time. All staff undertook a range of training. The manager was a qualified trainer. They and other senior staff assessed staff caring for people to make sure they did this well. There were regular meetings for staff with their line manager. These included individual supervision and appraisal meetings as well as meetings with a group of other staff. The provider used a range of different systems to help communicate effectively with staff and make sure they felt supported and well informed.

People told us staff arrived on time and stayed for the agreed length of time. People using the service and relatives felt staff were well trained and understood how to care for them well. Their comments included, ''I feel the carers are well qualified'', ''They understand [person's] needs and health conditions'' and ''They are on the ball, they spot any changes in [person's] health and let the district nurses know.''

Most of the staff told us they were happy with the way in which their work was organised. They felt well trained and supported. One member of staff raised a concern about short notice changes to their rota. We discussed this with the management team who explained they tried to make sure staff always had the information they needed in good time. They said short notice changes were only made if another staff member was unable to attend a visit. The staff undertook a range of training which helped them provide effective care and treatment. The management team explained not all staff had completed training to understand best practice for supporting people with learning disabilities or autistic people. This training had been arranged to be completed in the next few months. Records confirmed this.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People received good support to manage their own medicines. They told us they were happy with this. They said staff helped to make sure they had the right medicines.

There were appropriate systems to help make sure medicines were managed in a safe way. Staff kept accurate records to show when medicines had been administered. The management team were able to see these electronic records in real time. This meant they could respond straight away if there was an error. The management team also undertook regular audits. The provider had taken appropriate action when errors had occurred. This included seeking medical advice, retraining staff, and sharing learning with other staff to avoid similar instances.

Staff undertook training to understand about safe medicines management. The managers assessed their knowledge and skills.