We carried out a review of the data available to us about Caronne Care Ltd 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 Caronne Care Ltd, you can give feedback on this service.
Caronne Care Ltd is a domiciliary care service and supported living service that provides personal care to people in their own homes and flats. At the time of the inspection the service was providing care to 130 people in East London. Only one person was living in their supported living service.
People’s experience of using this service and what we found
There were systems in place to safeguard people from abuse with concerns being reported and investigated. However, we have made a recommendation to seek best practice with regards to incident investigation. Risks to people were assessed and mitigated. Staff recruitment processes were robust and there were enough staff working at the service to support people safely. Some people told us staff were not always on time, but the provider had responded to timekeeping issues by adopting a new electronic system for improved call distribution and monitoring. Medicines were managed safely, though we initially had concerns with the supported living service. However, this element of the service was new, and the registered manager made changes quickly once issues were identified. There were infection control measures in place and lessons were learnt when things went wrong.
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 sought people’s consent when providing care, however, we have made a recommendation the service follow best practice guidance on the Mental Capacity Act and consent as some language used in documents was incorrect and there were unnecessary signatures of people consenting to care which wasn’t their own. People’s needs were assessed before they began using the service. Staff received induction, training and supervision. People were supported with food and drink. Staff at the service communicated well with each other and people were supported with their health care needs.
People spoke highly about the management of the service. Managers and staff were clear about their roles. The provider knew they had a duty of care to people and their associated regulatory requirements. There were quality assurance processes were in place. People and staff were able to engage with the service. The service worked with other professionals to benefit people using the service and their care.
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 10 January 2018).
Why we inspected
We received concerns about staff knowledge and effectiveness with medicine management. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained the same; good. This is based on the findings at this inspection.
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.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good. The action plan set out the action they planned to take and during the inspection we found it had been taken and issues had been addressed.
This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and younger disabled adults. 117 people were using the service at the time of our inspection.
The service had a registered manager in place. 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.
Appropriate safeguarding procedures were in place and people told us they felt safe using the service. Risk assessments provided information about how to support people in a safe manner. There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Medicines were managed safely. Staff had a good understanding about infection control issues and used protective clothing to help prevent the spread of infection. Lessons were learnt when accidents or incidents occurred to help improve the service.
People’s needs were assessed before they began using the service. Staff received training and supervision to support them, in their role. Where the service supported people with meal preparation they were able to choose what they ate and drank. People were supported to access relevant health care professionals and the service worked with other agencies to support people. People were able to make choices for themselves where they had the capacity to do so and the service operated in line the Mental Capacity Act 2005.
People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.
Care plans were in place which set out how to meet people’s individual needs and these were subject to review. The service had a complaints procedure in place and people knew how to make a complaint.
Staff and people spoke positively about the registered manager. The service had various quality assurance and monitoring systems in place, which included seeking the views of people on the running of the service.
Caronne Care Ltd is a domiciliary care agency providing support to people in their own home. At the time of the inspection there were 37 people using the service.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 who used the service told us their carers were often late and this meant they had to wait for personal care or their medicines putting people at risk of unsafe care.
People felt safe with their carer and said they always introduced where they were from when they attended their home. Relatives told us they felt they had been given peace of mind as the carers kept they family member safe.
People received their medicines in a safe way and staff demonstrated they knew how to administer medicines safely. Staff were supported in this area with regular training and competency tests in medicines.
The service carried out recruitment safely and ensured pre-employment checks were completed before staff started to work in the community on their own.
Risk was assessed and records showed that the service performed detailed assessments of people’s home environment and equipment used to keep people safe and if necessary to request a an assessment for further equipment to protect people in their home for example a commode to support going to the toilet safely.
Staff received regular supervision in one to one sessions and in a group setting. Staff had commented that one to ones were sometimes not always in private. We have made a recommendation in this area.
The registered manager told us that staff had commenced the care certificate and records showed some staff had completed this training which they said was very helpful for their role.
Staff demonstrated a good understanding of the Mental Capacity Act 2005 and gave examples of how they supported people to make their own decisions when delivering care and when an assessment would be needed to assess capacity.
People and their relatives told us that the registered manager and staff were caring. People said the staff were very kind and lovely. Staff told us they would sit and talk with people and engage with them even for an extra five minutes after their shift has finished as they may not see anyone else.
People were involved in their care asked about their preferences and how they would like to receive care so that care was personalised to their needs. Consent was requested before care was given and when personal care and medicines were to be administered. Staff told us they did not force people to do anything they did not want to do.
People had support plans which were reviewed regularly with the registered manager and their relative. Records showed that the service was responsive to people’s needs and acted when they observed deterioration in people’s care needs or when they improved. Records showed that the registered manager had updated people’s care plan when they had become more independent to feed themselves.
People knew how to make a complaint about the service and records showed that they were recorded in line with the complaints policy. Records confirmed that the registered manager called people back promptly.
Notifications concerning safeguarding had not been sent to the CQC, the registered manager had notified the local authority. However they had not informed the CQC as required by the regulations.
Quality assurance at the service was not always robust. The registered manager showed us auditing tools they had to check medicines and daily logs that staff completed but they were not being consistently completed as there were blank forms. The registered manager told us that issues identified were picked up in staff supervision but we did not see records to show how this was audited.
People were asked to provide feedback on the service as were staff and we saw the service had received positive comments on the quality of the care. People had requested that staff arrive on time and staff acknowledged that this was area that should improve for people.
People, their relatives and staff said they thought the registered manager was good and easily approachable.
We found three breaches of the regulations.