Background to this inspection
Updated
8 September 2022
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 two inspectors, CQC’s Executive Director of Operations and an Expert by Experience. 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 and specialist housing.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was not a registered manager in post. However, there was a manager who was in the process of applying to become registered.
Notice of Inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection. Inspection activity started on 9 June 2022 and ended on 6 July 2022. We visited the location’s office on 9 June 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from 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 eight people who used the service and 6 relatives. We spoke with eight staff including the manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at a range of management records including supervision, quality audits and care visits. We also reviewed seven staff recruitment files and five people’s care records. After the office site visit, we continued to liaise with the service. The registered manager sent us documentation we asked for and clarified any queries we had.
Updated
8 September 2022
About the service
Caremark (Redbridge and Waltham Forest) is a domiciliary care agency providing personal care to adults and children. 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 our inspection there were 56 people using the service who received personal care.
People’s experience of using this service and what we found
People were safeguarded from the risk of harm and abuse. Staff were recruited safely. People were protected from the risks associated from the spread of infection. Medicines were managed safely. People had risk assessments to protect them from the risks they may face. We have made a recommendation about risk assessments.
People’s needs were assessed before they began to use the service. The provider worked jointly with healthcare professionals to ensure people’s needs could be met. People were supported with nutrition and hydration. Staff were supported with training and supervision. 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. Staff obtained people’s consent before delivering care.
Staff demonstrated they knew the people they supported well and understood how they preferred to receive their care. People and relatives were able to express their views about the care that was provided. Staff knew how to respect people’s differences. People’s privacy, dignity and independence was promoted.
Staff understood how to provide a personalised care service. People’s choices were respected. Care records were personalised, contained people’s preferred method of communication. People and relatives knew how to complain and the provider had a system to record concerns. The provider understood how to provide end of life care in accordance with people’s wishes.
People, relatives and staff spoke positively about the management of the service. Staff and management understood their roles and responsibilities. The provider had a system to obtain feedback from people and to audit the quality of the service in order to make improvements.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 02/02/2022). We identified breaches at the last inspection in relation to safeguarding people from abuse, person-centred care, staffing, recruitment, receiving and acting on complaints, dignity and respect, safe care and treatment and good governance.
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made but the provider remained in breach of the regulations.
At our last inspection we made two recommendations around communication and obtaining consent to care. At this inspection we found improvements had been made in these areas.
This service has been in Special Measures since 2 February 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to the provider operating from an unregistered location. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the well-led section of this full report.
We have made a recommendation about reviewing risk assessments.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.