We carried out a review of the data available to us about Caremark - Charnwood 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 Caremark - Charnwood, you can give feedback on this service.
Caremark - Charnwood is a domiciliary care agency providing care and support to people living in their own homes. At the time of our inspection, there were 45 people using the service, many of whom required 2:1 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.
People’s experience of using this service and what we found
People were kept safe by staff who understood how to safeguard them from abuse, and the actions they needed to take to protect people from the risk of harm. There were sufficient numbers of staff to support people and staff were recruited safely. There were appropriate infection control practices in place and people were supported to take their medicines safely.
Staff received training, supervision and support so they could effectively perform their roles and meet people needs. People were provided with care and support that ensured they had good nutrition and hydration and access to healthcare that maintained their health and wellbeing. 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 were kind, caring and treated people with respect and dignity. People were encouraged to remain independent where possible and were supported to be at the centre in planning and developing their care.
People and those important to them were at the centre of the assessment and care planning process. People were supported to express their wishes and preferences regarding their care. Staff knew people well and used this knowledge to provide personalised care. Some care plans required further development to ensure they reflected the personalised care provided. People and relatives were confident to raise concerns and complaints if they needed to.
People, relatives and staff spoke positively about the management and leadership of the service, as being open and transparent. The provider had systems in place to monitor the quality of the service to ensure people received good care. People, relatives and staff were given the opportunity to feedback on their experience of the service and contribute to the improvement and development of the service.
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 requires improvement (published May 2020). At our last inspection we found the provider was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Caremark - Charnwood is a domiciliary care agency providing care to people in their own homes. The service was supporting 60 people at the time of the inspection.
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.
People's experience of using this service and what we found
People did not receive their medicines safely and as prescribed. Medicine management practices were not safe. The provider needed to make improvements to how medication management was recorded.
There were insufficient risk assessments in place to keep people safe from harm. People’s needs were assessed however risk assessments were generic and not personalised to their needs.
Quality assurance systems were not adequately in place to assess, monitor and improve the quality and safety of the service provided.
People felt safe and well cared for. People's preferences were respected, and staff were sensitive and attentive to people's needs.
There were sufficient numbers of staff employed to ensure people's needs were met at the time of the inspection.
Recruitment practices were safe and staff received the training they required for their role.
Staff were aware of their responsibilities to safeguard people and the service had procedures in place.
Staff ensured people's rights were respected.
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 supported this practice.
We identified a breach in relation to safe care. The provider failed to ensure medicines were administered safely and risk assessments completed adequately. You can see what action we have asked the provider to take at the end of this full report.
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 requires improvement (report published 20th February 2019).
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.
Not everyone using Caremark - Charnwood received the regulated activity; personal care. CQC only inspects the service received by people provided with personal care, help with tasks related to personal hygiene and eating. Where they did we also took into account any wider social care provided. Of the 61 people using the service, 57 were receiving the regulated activity, personal care.
At our last inspection in May 2016, the service was rated overall ‘Good’. At this inspection we found the service ‘Required Improvement’.
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.
The provider’s safeguarding processes had not always been followed by the management team when a safeguarding allegation had been received.
Whilst the risks associated with people’s care and support had been identified, not all had been included in the risk assessment process. Risk assessments seen were generic in content and lacked personalised information.
Whilst auditing systems were in place, these did not always pick up omissions within the documentation held at the service.
Whilst the majority of people received the calls they required, we evidenced one occasion when a person’s call, which was mainly to prompt them to take their medicines, had been missed.
People and their relatives told us they felt safe with the staff who visited them. Staff had received training on the safeguarding of adults and knew what to do if they were concerned for someone’s welfare.
Appropriate checks had been carried out when new members of staff had been employed to make sure they were suitable to work at the service. Staff members had received an induction into the service and relevant training had been provided to enable them to meet people’s needs.
The staff team had received training in the management of medicines. Where people required support with their medicines, they were supported in line with the provider's medicines policy.
People were supported to maintain good health. They were supported to access relevant healthcare services and they received on-going healthcare support. People who required support at mealtimes were supported to have enough to eat and drink to keep them well.
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 supported this practice.
The staff team had received training in infection control and understood their responsibilities around this. People were protected by the prevention and control of infection.
The staff team were kind and caring and treated people with dignity and respect. People were supported to make choices about their care and support on a daily basis.
There were arrangements in place to make sure action was taken and lessons learned when things went wrong and a business continuity plan was available to be used in the event of an emergency or untoward event.
Whilst the staff team had received training on the Mental Capacity Act 2005 (MCA) not all could remember completing this. People's consent was always obtained before their care and support was provided. The management team understood the principles of the MCA.
We recommend all staff receive training in and are reminded of the principles of the Mental Capacity Act (MCA) 2005.
Plans of care had been developed with the people using the service and their relatives. This enabled the management team to identify their individual care needs and provide support in a way they preferred. An end of life care policy was in place for the staff team to follow.
The staff team felt supported by the registered manager and the management team and told us there was always someone to talk to if needed.
People had the opportunity to be involved in how the service was run. They were asked for their opinions of the service on a regular basis. This was through care reviews and through the use of surveys.
A formal complaints process was in place and people knew who to talk to if they had a concern of any kind.
The provider and registered manager were aware of their registration responsibilities including notifying CQC of significant incidents that occurred at the service.
Further information is in the detailed findings below.
Caremark –Charnwood is a domiciliary care agency that provides personal care to people in their own homes. On the day of our inspection the service was supporting 45 people.
The service had a registered manager. 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 and their relatives told us that they felt safe. Staff were aware of their responsibility to keep people safe. Risks were assessed and managed to protect them from harm and staff understood what to do in emergency situations.
Safe recruitment practices were being followed. Systems were in place to ensure that people received support at the times that they wanted to and this was monitored. People were supported by a number of different staff and most expressed a preference for fewer different staff to support them.
People received their medicines as required. Medicines were administered safely by staff who were appropriately trained and competent to do so.
Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported. Their competence to do their role was regularly assessed. Some people felt that less experienced staff required a greater level of training and supervision.
People made decisions about their care and the support they received. People were involved and their opinions sought and respected. The registered manager understood their responsibility to ensure people were supported in line with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
People’s nutrition and hydration needs were assessed and met. People’s health needs were met and when necessary, outside health professionals were contacted for support. People’s health records were being maintained.
People’s independence was promoted and people were encouraged to make choices. Staff treated people with kindness and compassion. People’s communication needs were identified and supported. Dignity and respect for people was promoted.
The care needs of people had been assessed. Staff had a clear understanding of their role and how to support people who used the service. People contributed to the planning and reviewing of their care.
People and staff felt that the registered manager was approachable and action would be taken to address any concerns they may have. People and staff were kept informed of changes to the service and their feedback was sought.
There were a range of audit systems in place to measure the quality and care delivered so that improvements could be made.
Care plan documents had been reviewed in recent months and updated at regular intervals. The information was well detailed and explained people's individual care and support requirements and their preferred routines. Staff confirmed that the care plan records were up to date and accurately reflected peoples' current needs.
These care plan documents also included information about the medicines people took, including the name of the medicine, the dose and frequency. This meant that people were protected from the risks associated with unreliable administration of medicines.
During our inspection we met two people who used the service, one with their relative present. We also spoke by telephone with four other people using the service and two relatives of people using the service.
We met with seven of the care staff employed by Caremark and spoke in detail with four of these and with the manager of the service.
The local authority had recently been supporting the provider by offering advice and expertise to them to help make improvements to the service.
Care plans showed that people's needs had been assessed and their views taken into account. The plans were not always as up to date as they needed to be to reflect recent changes in people's circumstances. Overall, the people we spoke with told us that they were satisfied with the support they received. One person explained this to us, 'It is all very good. The staff come on time. They are very nice and very reliable.'
Information in medication care plans and risk assessments gave useful information but arrangements for recording the administration of medication indicated people did not always have their prescribed medicines when they should.
Staff received support from senior staff and attended regular training to help keep their skills and knowledge up to date.
The provider asked people for their views on the quality of the service. Unannounced spot checks took place to observe staff and provide feedback on their performance.
People using the service who we spoke with were unfamiliar with the formal complaints policy but felt they would be able to raised concerns with staff, should they have the need to. One of the people we spoke with told us, 'I have no complaints whatsoever. If I did I would let them know.'
Staff received computer based induction training when they commenced their employment and worked alongside colleagues to help learn different aspect of the job. There were no formal arrangements in place to support and monitor staff and to help ensure that they had the appropriate skills and knowledge to carry out their duties safely.
Assessments were completed prior to people using the service and information was gathered to help plan the care and support people needed. People were involved in this process by sharing information about their likes, dislikes and preferred routines.
Staff understood the potential risks to people's safety and wellbeing and knew how to raise concerns if they felt a person was at risk of harm or abuse.