Background to this inspection
Updated
31 October 2019
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 Care Act 2014.
Inspection team
The inspection team consisted of one inspector and one assistant inspector. An expert by experience also supported in making telephone calls to people who used the service in order to gain their views. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection because we needed to ensure people had consented for us to make home visits and to be contacted by our Expert by Experience.
Inspection activity started on 10 October 2019 and ended on 11 October 2019. We visited the office location on 10 and 11 October 2019.
What we did before the inspection
Before the inspection we reviewed information we already held about the service. This included reviewing information we had received from the provider as notifications. Notifications are information about events that providers are required by law to tell us about.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection-
During the inspection we spoke with 17 people who used the service and one relative over the telephone about their experience of the care provided. We also completed three home visits to people receiving care and support. We spoke with and received feedback from eight care staff, the registered manager and the director.
We reviewed a range of records. This included reviewing 10 care records for people receiving support including their care plans, risk assessments and medicine records. We looked at six staff files in relation to recruitment and supervision and reviewed a number of other records relating to the management of the service, such as accidents and incidents, audits, company policies, complaints and staff training.
After the inspection –
We continued to seek clarification from the registered manager to validate and follow up on evidence we found. We looked at training data and quality assurance records. We received further information requested during the inspection.
Updated
31 October 2019
About the service
Caremark (Worthing), referred to as Caremark in this report, is a domiciliary care agency providing personal care to approximately 140 people 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 relating 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
During our inspection we identified one person was at risk in relation to their swallowing. We also identified people’s risk assessments and related management plans did not contain sufficient detail to give staff guidance on how to minimise risks to people. However, staff knew how best to care for people and knew people well. The registered manager took immediate action to keep the person with swallowing difficulties safe and updated people’s risk assessments where needed.
People spoke highly of the service they received from Caremark. People told us they would recommend the service to others. Comments included; “I would recommend them. We’ve got no complaints. They are very respectful and helpful. They do everything for us”, “I would recommend them. Someone asked me the other day and I gave them the phone number. They’re really good to me, I wouldn’t want to change them” and “I would certainly recommend them, because of the attention and help I’ve had and I would like other people to have the same help and care.”
The service had strong person-centred values and placed people’s wellbeing at the heart of their work. People received personalised support which met their needs and preferences. Staff knew people well and worked hard to enable them to share their views, make choices and live active lives as independently as possible. People were fully involved in the planning and delivery of their care.
People’s needs were assessed and care was planned and delivered to meet legislation and good practice guidance. The registered manager was in the process of improving people’s care plans in order to make them more person centred. Where these were in place, people’s support plans contained personalised information which detailed how they wanted their care to be delivered.
The organisation was dedicated to enabling people to be part of their local community and regularly put on events for people to attend. Where people struggled with transport and were more isolated, staff organised for this to be provided for them. The service worked closely with local services, professionals and organisations to give people access to opportunities and services.
People received their medicines as prescribed by their doctor. Incidents and accidents were investigated, and actions were taken to prevent reoccurrence. Staff felt strongly supported and received training and supervision to meet the needs of the people they cared for.
People were protected from potential abuse by staff who had received training in safeguarding and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable to abuse and avoidable harm.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive ways possible and in their best interests. The policies and systems in the service supported this practice.
People were supported by kind and caring staff who worked hard to promote their wellbeing. Staff were proud to work for the service and treated people with respect and dignity. The service promoted equality and diversity and worked hard to meet all of people’s individual needs.
There was strong leadership at the service. People and staff spoke highly of the registered manager and there was a positive culture at the service with people and staff feeling their voices were listened to.
Although we identified concerns during the inspection, there were thorough quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.
We have made a recommendation about comprehensive risk assessments being in place.
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 22 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.