Caremark (Brentwood & Basildon)

Caremark Limited is a domiciliary care agency that provides personal care 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 inspection 13 people were using the service and 12 of these were receiving personal care.

People's experience of using this service:

People told us they felt safe with staff and were happy with the service they received. People received their care calls from regular staff who knew them well. Staff were generally on time and stayed for the full duration of the agreed call times. All people asked said staff were kind and caring and they would recommend the service to others. Positive comments were also made about the helpfulness, visibility and professionalism of the registered manager.

Risks to people had been assessed and staff knew what to do to keep people safe. People’s medicines were safely managed by staff who had been trained and assessed as competent. Staff followed good infection control practices and wore gloves and aprons as required.

People’s needs had been assessed and their wishes and preferences were known and respected. Staff were trained and competent in their role. Staff received supervisions and appraisals to monitor their performance and identify any learning needs.

Where required people received help with eating and drinking which met their needs and preferences. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

Staff listened to people and knew people well. People were treated with dignity and respect and their independence was promoted. People’s privacy was maintained. The service was responsive to people’s needs and provided care and support the way people liked it. There were policies and procedures in place to manage complaints appropriately.

We made a recommendation about people's preferences for end of life care.

The service was well led by a longstanding registered manager who was ‘hands-on’ and provided care and support. This meant they could monitor staff performance and check people were satisfied with the service.

Quality assurance processes were in place to monitor safety and quality and identify any areas requiring improvement. People and staff were asked for their feedback and included in how the service was run.

Why we inspected: This was a planned inspection based on the previous rating.

Rating at last inspection: Good. (Last report published July 2017).

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Follow up: We will continue to monitor and inspect this service based on the information we receive.

The inspection was announced and took place on 8 June 2017 with follow up visits on 9 June 2017. We gave the manager 48 hours' notice of the inspection because we needed to be sure that staff and people using the service would be available to speak with us. At the time of inspection there was a registered manager in post. 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 and associated Regulations about how the service is run.

People were protected from harm by staff who understood their safeguarding responsibilities. Staff recognised the signs of abuse and knew what action to take if abuse was suspected. Staff were aware of the whistle-blowing policy and were confident that if they raised concerns these would be listened to and actioned appropriately.

People had risk assessments and management plans in place which provided guidance to staff on how care was to be provided in order to prevent or minimise the risk of people coming to harm.

People who required support with medicines were assisted by staff who were trained and assessed as competent to give medicines safely.

Robust recruitment processes were in place to ensure the safe recruitment of staff. There were sufficient numbers of staff deployed to safely meet people's needs.

Staff received a comprehensive induction and on going training to equip them with the knowledge and skills to care and support people effectively. Supervision and spot checks were regularly carried out to monitor and assess staff competency.

The legal requirements of the Mental Capacity Act 2005 (MCA) were followed when people were unable to make specific decisions about their care. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The service supported people with decision-making and involved people’s family members or representatives in the decision-making process.

Where people were assisted at mealtimes, they were supported to have enough to eat and drink which reflected their preferences and met their health needs. The service worked with health and social care professionals when staff had concerns about people's health and wellbeing.

Staff were kind and caring, knew people well and treated them with dignity and respect. The service adopted a person-centred approach and care was tailored to meet people's individual needs.

Care plans detailed how people wished to be supported. People were involved in the care planning process and in decisions about their care and treatment.

There were systems in place to support people to make a complaint or raise concerns about the service. Feedback from people who used the service was actively sought and the information was used to improve the service people received.

Staff enjoyed working at the service . They were supported by the registered manager who they described as approachable and accessible.

There were systems in place to monitor the quality and safety of the service and action was taken to make any necessary improvements to develop the service.