We carried out a review of the data available to us about CM Community Care Services Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about CM Community Care Services Limited, you can give feedback on this service.
CM Community Care Services Limited provides personal care to people, including older people living in their own homes. There were 65 people using the service at the time of our inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People's experience of using this service and what we found
The service was exceptionally well led. The feedback we received, from people, relatives and professionals on the company and the staff team was overwhelmingly positive. This was supported by the motivation of the nominated individual and staff team to ensure they delivered a high-quality service for the people they supported. There was an emphasis on continual learning and the provider and staff used this to develop the service to go above and beyond for people. Putting the person at the centre of this the staff worked alongside them and their families to deliver initiatives that had been set up to enhance people’s quality of life.
There were strong links with the local authority, the wider community and external agencies who they worked in partnership with. People, relatives and staff felt involved with the running of the service and were actively engaged with the provider on continually improving. They were listened to and their feedback and ideas were used to ensure the service continued to develop.
The provider had gone above and beyond to ensure people’s wellbeing was considered offering numerous no chargeable activities which helped people’s isolation and confidence. The provider was proactive in managing people’s health needs and had created and were involved with initiatives that helped the reduction of hospitalisation. Training opportunities were offered to friends and families to help off extra support and those who had taken this had praised the importance of it.
There were robust systems in place to ensure the quality of the service was checked and monitored. When areas of improvement had been identified it was evident these were actioned. These systems were reviewed and evaluated to ensure that lessons were continually learnt and measures in place to mitigate the risk of these reoccurring. There was a clear understanding of responsibilities and this was demonstrated by the provider working in line with duty of candour. We received notification as required by staff who had clear lines of delegation and understanding of their role.
Individual risks to people were considered and safeguarding procedures were in place. Medicines were managed in a safe way. There were enough staff available for people. Infection control procedures were implemented. Lessons were learnt when things went wrong in the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 18 January 2019).
Why we inspected
The inspection was prompted in part due to concerns received about leadership and record keeping. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The service provides a rehabilitation service and Domiciliary care service to people living in their own home. All calls to peoples home are monitor electrically, where a call in short or missed this gives an alert to the office , who then contact the staff member to establish the cause.
Care records were personal to the individual which contained detailed risk assessments including risks associated with pressure care so staff had the information to support people safety.
Complaints were investigated in full with an outcome recorded. Complaints were responded too in writing with the outcome, giving details of any lessons learnt as a result of the complaint.
Systems were in place to monitor the quality of the service provided. This ensured the service was proactive to improvement rather then reactive.
At the time of our inspection, 96 people were supported with their personal care needs by the service. There was a registered manager in post. 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.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
People continued to be safe when receiving support and staff understood how to protect people from harm. People’s risks were assessed, monitored and managed to ensure they remained safe. People were supported by sufficient numbers of staff who were recruited safely. People's medicines were managed safely. Staff understood their responsibilities in relation to hygiene and infection control.
People continued to receive effective care. People continued to receive care from staff who had the skills and knowledge required to effectively support them. Support was delivered in line with good practice guidance. People's rights were protected because the manager and staff had an understanding of the Mental Capacity Act 2005 (MCA). Staff supported people to meet their nutritional needs and supported them to access health care professionals when required. People were involved in how their care was planned.
People continued to receive support from staff that were kind and caring and responsive to their needs. People's privacy was respected, and their dignity and independence promoted. People were able to make choices about their day to day lives. People knew how to raise any concerns or complaints and these were responded to in a timely manner.
The service continued to be well led, and the manager understood their role and responsibilities. Staff felt supported by the management team and were confident that they could approach the manager or provider and would be listened to. People and staff were encouraged to give feedback, and their views were acted on to develop the service. The provider worked in partnership with other agencies and teams, and there were systems in place to drive improvements.
C M Community Care provides personal care to people in their own homes. At the time of our inspection they were providing care to 95 people in their own homes.
There was a registered manager in place at the time of our inspection. 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 told us they felt safe with the staff who provided their care. Staff knew how to protect people from suspected abuse and what to do should they suspect abuse had taken place. People’s risks were managed by staff who had the knowledge to ensure the care they provided was safe. There were sufficient staff to meet people’s needs. Staff supported people to have their medicines when they needed them.
People told us staff had the knowledge and skills to support them. Staff told us the training they received enabled them to meet people’s needs. People had capacity to make decisions about their care. Staff supported people to meet their nutritional needs when required. Staff understood what action to take when people’s health needs changed.
People were supported by kind and considerate staff. People told us staff encouraged them to maintain their independence. People were supported by staff who respected their privacy and dignity.
People were involved in their care and supported by staff who understood their needs and respected their individual choices and preferences. When people had complained there was a system in place which meant they would be listened to and any appropriate action would be taken.
People told us they were happy with the care they received and would recommend the service to others. People had the opportunity to comment on how the service was run. Staff felt supported in their role. The quality assurance system in place meant that people received care which was safe and effective and responsive to their individual needs.
CM Community Care Services Limited -30 Waterloo Road provides personal care for people in their own homes. At the time of our inspection there were approximately 279 people receiving a service.
There was a registered manager in post. 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 not always fulfilling their legal responsibility to keep us informed about any accidents or incidents that occurred whilst people were receiving a service. This is a breach of regulations. You can see what action we told the provider to take at the back of the full version of the report.
People were receiving an improved service because they were not experiencing missed calls however, improvements in the management and monitoring of the quality of the service were needed to ensure that people received a personalised service at their preferred times and with more regular staff.
People were kept safe from harm because staff were knowledgeable about the types and signs of abuse and the actions to be taken if abuse was suspected. Risks associated with people’s care had been assessed and plans put in place to manage them. Recruitment processes helped to ensure that only suitable staff were employed to support people in their own homes.
There were sufficient numbers of staff available to ensure all calls were attended.
People were supported to receive their medicines as prescribed.
People were supported by staff that received training, supervision and advice to carry out their roles.
Staff ensured that people gave consent to the care they received and supported them to make decisions and choices about their day to day care so that their human rights were promoted.
People were supported by staff that were kind, caring and respectful and that helped people to remain as independent as possible.
People were involved in planning their care and reviews so that changing needs were identified.
People were able to raise any concerns they had.
We inspected the service 26 August 2015. The inspection was unannounced. We inspected the service to make sure the requirements of the warning notices in relation to safe care and governance had been met. We found the provider had made improvements to their systems which check whether people received the calls they needed. Further improvements were needed in the way that medicines were managed.
CM Community Care Services Limited -30 Waterloo Road provides personal care for people in their own homes. At the time of our inspection there were approximately 350 people receiving the service.
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 provider had improved upon the length of time staff were spending with people, although some calls were still cut short and missed.
The provider had improved the system for supervising staff and making sure they were supported when they delivered care to people.
The provider had improved the checks they undertook as part of the quality monitoring of the service. Changes in the management of the service had taken place but improvements were still needed to make sure records were up to date, people were supported with their medicines appropriately and calls were delivered on time.
We undertook an unannounced inspection of CM Community Care Services Limited - 30 Waterloo Road on 22 May, 26 May and 28 May 2015. At the last inspection in July 2014 the service was meeting the regulations with all of the areas that we looked at, but was rated overall as “requires improvement”.
CM Community Care Services Limited - 30 Waterloo Road provides personal care for people in their own homes. At the time of our inspection there were approximately 350 people receiving the service.
There was a registered manager in post at the time of our inspection. 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.
Some of the people and relatives we spoke with praised the service, but some people and relatives expressed concerns about the safety and quality of the service provided.
Some people and relatives told us the service was safe, while others felt it was not. People told us about specific instances where they had not felt safe with staff.
Staff were not always on time for visits and this effected people negatively. Call times were sometimes cut short. Staff’s ability to be on time and complete full visit times was sometimes affected by them being given additional visits to complete.
We could not be assured that people always received the medicines they needed to support their health, as medicines administration records showed significant gaps in people being given their medicines.
Staff did not always use appropriate infection control procedures while providing care. However, staff we spoke with were aware of proper infection control techniques.
Some people and relatives felt staff were skilled at their jobs, while others did not. Staff told us they had received adequate training.
Most people said staff respected their rights. The registered manager demonstrated that they knew what steps to take if they suspected a person’s ability to make decisions was declining.
While some people were provided with adequate food and drink by staff, some people’s regular food intake was affected by inconsistent visit times.
Some people found staff to be caring, while others had raised concerns about staff attitude. Some people told us they felt listened to by staff and management, but others told us that the provider was not responsive to them.
Some people told us that staff respected their dignity and privacy. However, we were given examples of when staff had failed to support people’s dignity. People told us they sometimes felt rushed by staff.
Some people told us that the staff who visited them frequently changed and so staff were less aware of their needs. Other people received care which suited their needs.
The provider advertised their complaints process to people, so they would know how to raise an issue. People gave us a variety of views on how well the provider handled complaints.
People held differing views as to whether the service was well managed. We found that the provider’s auditing processes were not effective in identifying some of the issues we discovered during the inspection. We found that some care records were not always consistent or updated.
Staff told us that they were well supported in their roles by the management team.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
The overall rating for this provider is ‘inadequate’. This means that is has been placed into ‘special measures’ by CQC. The purpose of special measures is to:
Services placed in special measure will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The inspection was announced, which meant we gave the staff and provider 48 hours notice that we would be inspecting the service. This was to ensure that the registered manager was at the office on the day of our inspection.
The service is registered to provide personal care to people living in their own homes. At the time of our inspection 343 people used the service.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
At the last inspection on 12 March 2014 the provider needed to make improvements to ensure people received care calls at agreed times and improve support for workers in relation to training. The provider sent us an action plan telling us what improvements they would make.
During this inspection we found that the provider had made improvements to training records to demonstrate that staff received mandatory training to undertake their role. This was confirmed by staff that we spoke with.
We found that people received late care calls and further improvement to service delivery was required. The registered manager told us that she had implemented a call monitoring system that was being tested in one geographical area before being rolled out to the remaining three geographical areas where the service provided care. She told us this system would identify where calls took place and when calls times were not completed on time to enable her to address this.
The provider had not consistently responded to concerns people had raised. This meant that the quality of service was not consistently delivered to the satisfaction of people who used the service.
Eight out of ten staff reported low morale and did not always feel supported in their role with respect to rotas and communication from the office.
During our inspection we found there was adequate staffing to meet the needs of people who used the service.
Arrangements were in place to request heath, social and medical support to help keep people well.
Staff were kind, caring and respectful to people when providing support and in their daily interactions with them.
There were processes in place to drive service improvements.
Records showed that we, the Care Quality Commission (CQC), had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.
As part of the inspection we spoke with five people and their representatives, nine staff and the provider. We looked at six people's care records. In addition to speaking to people we posted 60 questionnaires to people who used the service to gauge their views. Seven people responded to these posted questionnaires, along with five representatives.
Most people told us they were happy with the service they received while others were less positive about their experience. The most common area of concern people expressed was about staff not arriving at the agreed times for visits.
People we spoke with were complimentary about staff. One person told us, 'They're good'. However, some people told us that newer members of staff seemed less skilled in delivering care and were not always aware of how to support people's needs.
The provider was implementing a new system which would assist in auditing aspects of care such as the arrival and departure times of staff on visits. One person told us that the provider did respond to issues, but that matters would start to reoccur after a period of time.
We found that people's consent to care was sought. One person said, 'Yes, they do ask permission'.
People received the care which was outlined in their care records, which was reviewed to meet their needs. One relative told us, 'X tells me they do a good job. They're responsive'.
Staff used equipment correctly and followed guidance to minimise the risk of infection. One person told us, 'They always wear gloves and aprons'.
Staff were skilled in carrying out their roles. However, we found that the provider did not maintain an up to date staff training record to assist with the identification of training needs.
The provider carried out audits of care to ensure people received safe care.
People told us they were aware of what was in their care plans and knew they were kept in their homes so that they could access them at any time. One person told us that the agency's staff were, 'friendly, quite pleasant'. One person said they were not always confident new staff were made aware of their needs and said, 'if they're new, I have to tell them'.
People told us that they had confidence in the staff that assisted them. They felt safe when staff were in their homes. One person told us, 'the girls are honest'. This person also told us, 'on the whole they're nicely presented; very, very polite, very pleasant'.
People felt able to raise issues which concerned them with staff or the agency's management. One person told us that the agency listened to their concerns and were 'very flexible'. Another person told us that staff, 'work in conjunction with each other' and the service was a 'lovely agency'. People recalled completing questionnaires, circulated by the agency, which asked for their opinion on the service provided.
We therefore visited the agency offices as part of this review, asked for an updated action plan and looked at information we have received about this provider since our last vist in February 2011.
People said they were involved in developing a support plan, which told staff about them. They had a copy of their support plan, which they kept in their homes. They told us that someone from the agency did come out and talk to them about their plan.
People told us that they felt confident to make a complaint although those we spoke to said they did not really have anything to complain about. People told us that they knew the staff well and could talk to them about anything. People said that staff were always respectful and always checked with them before supporting them or delivering any personal care.
People told us that they received support with their medication when they needed it and that staff always left them feeling safe.