Caremark (Cheshire North East)

Updated 30 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of an inspector and a regulatory coordinator.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

The inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 9 December 2023 and ended on 21 December 2023. We visited the location’s office/service on 11 December 2023.

What we did before the inspection

We reviewed the information we held about the service and contacted the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 7 relatives about their experience of the care provided. We spoke with 5 staff including the managing director and care staff.

We reviewed a range of records, including 6 people's care records. We looked at 3 staff files in relation to recruitment and staff support, and a range of records relating to how the service operated and was managed.

Updated 30 January 2024

About the service

Caremark (Cheshire North East) is a domiciliary care agency providing personal care and support to people living in their own homes.

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. At the time of the inspection, 56 people were receiving support with personal care.

People’s experience of the service and what we found:

The provider undertook some quality assurance audits and checks, however they had not identified all the issues we found during the inspection. Records were not always sufficiently robust. This related to aspects of risk management, medicines records and to demonstrate full compliance with the MCA. Systems to improve the provider's oversight of training and staff supervisions were being further developed.

Where necessary staff reported safeguarding concerns to the local authority. However, whilst the provider was aware of the need to notify CQC about certain incidents and events, they had not fully understood all aspects of this requirement. We have made a recommendation about this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, staff had not always followed the systems/policies in place. This related to records for capacity assessments and best interest decisions. We have made a recommendation about this.

The provider ensured there were sufficient numbers of suitably trained staff, who had been recruited safely. Overall, people were supported to receive their medicines safely and risks were managed. However, the electronic recording system in relation to medicines needed to be further adapted and some records needed to be more in-depth about actions being taken. The provider was addressing this.

People told us they felt safe and were complimentary about the care provision. People’s needs were met in a person centred way and the care was flexible. Systems were in place to protect people from abuse or avoidable harm.

People’s needs were assessed and care and support was delivered in line with current standards to achieve effective outcomes. People had been included in discussions about their care. Staff worked well with other agencies and acted on any changes in people’s needs.

There was a positive and open culture at the service, with good communication. The provider had already devised a development plan to drive ongoing improvements in the quality of the care. The provider worked in partnership with others and people’s views and feedback were sought.

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 9 June 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. During the inspection we found there was a concern in relation to consent and mental capacity, so we widened the scope of the inspection to include effective.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection by selecting the 'All inspection reports and timeline’ link for Caremark (Cheshire North East) on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach of regulation in relation to the provider's overall governance. We have made 2 recommendations in relation to consent to care and regulatory requirements.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.