Caremark (Mansfield & Ashfield)

Updated 19 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 17 April 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure the registered manager would be available.

Before the inspection, we reviewed information we held about the service, which included notifications they had sent us. A notification is information about important events, which the provider is required to send us by law. We also contacted Local Authority commissioners of adult social care services and Healthwatch and asked them for their views of the service provided.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

The inspection team consisted of an inspector and two Experts by Experiences. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They carried out the telephone interviews with people prior to the office-based inspection. They spoke with 23 people who used the service. The inspector visited the office location to see the registered manager, office staff and to speak with care staff.

The inspection was informed by feedback from the telephone interviews as well as questionnaires completed by a number of people using service, relatives, staff and community professionals. We sent 174 questionnaires out and received 34 responses.

During the inspection, we spoke with four members of the care staff, the registered manager and a number of office based staff

We looked at records relating to five people who used the service as well as three staff recruitment records. We looked at other information related to the running of and the quality of the service. This included quality assurance audits, training information for care staff, staff duty rotas, meeting minutes and arrangements for managing complaints.

We asked the registered manager to send us copies of various policies and procedures after the inspection. They did this within the requested timeframe.

Updated 19 June 2018

We carried out an announced inspection of the service on 17 April 2018. Caremark (Mansfield) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. Not everyone using Caremark (Mansfield) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

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.

At the time of the inspection, 100 people received some element of support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection, the service was rated as ‘Good’ overall, however the question, ‘Is the service well-led?’ was rated as ‘Requires Improvement’. At this inspection, they maintained the overall rating of ‘Good’. The rating for the question, ‘Is the service well-led?’ improved to ‘Good’. The rating for the question, ‘Is the service effective?’ changed from ‘Good’ to ‘Requires Improvement’. This was because people had raised some concerns that staff did not always arrive for calls on time. We also had concerns that people’s rights were may not be protected when decisions were made for them.

People told us they felt safe when staff supported them. Staff understood how to report concerns about people’s safety to reduce the risk of people experiencing avoidable harm. There were enough staff to support people and the risks to their safety were assessed and acted on. People’s medicines were managed safely. Staff understood how to reduce the risk of the spread of infection. The provider had processes in place to investigate accidents and incidents and to learn from mistakes.

Some people felt staff did not always arrive on time for their calls. People’s care was provided in line with current legislation and best practice guidelines. Staff were well trained and understood how to support people effectively. Staff performance was regularly monitored although the frequency of these supervisions had recently reduced. People were supported to follow a healthy diet and staff supported people effectively with their meals. Information was available to support staff with caring for people. Other health and social care agencies were involved where further support was needed for people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Some improvements were required to ensure all people’s rights under the Mental Capacity Act (2005) we respected. .

People and relatives liked the staff and felt they treated them or their family members with dignity and respect. People were encouraged to do things for themselves and were enabled to make decisions about their care. Staff treated people with compassion and communicated effectively with people.

People were assessed before joining the service to ensure their needs could be met. People’s care records were person centred and staff provided them with support in the way they wanted. People felt care staff responded effectively to complaints or concerns raised, however some felt office based staff did not always do so. People’s diverse needs were discussed with them and respected.

The registered manager carried out their role in line with their registration with the CQC. They now ensured all notifiable incidents were reported to the CQC. Staff respected the registered manager with staff encouraged to carry out their role in line with provider’s aims and values. High quality staff performance was rewarded. People and staff were given the opportunity comment on how the service could be developed and improved. Auditing processes were in place and these had already identified some of the issues we identified and were being acted on.