Caremark (Thanet)

Updated 28 November 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 was carried out by one inspector, two assistant inspectors 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.

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 that people had consented to be contacted by our Expert-by Experience.

Inspection activity started on 3 September and ended on 10 September. We visited the office location on 3 September.

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. We reviewed public reviews of the service and sought feedback from the local authority where the service was based.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with 40 people who used the service and seven relatives. We spoke with 15 members of staff including 10 care and support workers, the registered manager, the care manager, the quality manager, the nominated individual and the PASS system Maven. The PASS system Mavern was a member of staff who was the internal expert in using the electronic care file and monitoring system, who had a lead role in monitoring and supporting staff to learn the system. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed the care files for 15 people and associated records of care and call monitoring information. We reviewed the files of ten staff including recruitment, supervision and spot checks. We reviewed training records, meeting minutes, audits, reports, complaints and compliments, incident records and other documents relevant to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 28 November 2019

About the service

Caremark Thanet is a domiciliary care service providing personal care to approximately 170 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 told us they received a personalised service from staff who demonstrated a caring and compassionate approach to their role. People told us they were involved in writing and reviewing their care plans. Staff told us they had enough information about people’s support needs and preferences to provide them with care.

People were protected from avoidable harm and abuse by staff who knew how to identify and escalate concerns. Risks faced by people during care were identified with clear plans in place to mitigate them. We saw where people’s risks changed, staff knew what to do and reported any concerns. Care plans were updated in response to changes in people’s risks and circumstances.

People were supported to take medicines by trained staff. However, care plans did not contain enough information about the medicines people were prescribed to ensure staff had the information they needed. We have made a recommendation about medicines care plans. People were supported to access healthcare services and to ensure they followed the advice of healthcare professionals.

The service worked closely with local community groups to offer people additional access to community activities, social events and networks to reduce the risk of social isolation. Staff researched people’s background and culture to ensure they provided sensitive and appropriate support.

People were involved in delivering training to staff about their experience of using care services. Staff were recruited locally and the values of the organisation were embedded from the early stages of recruitment. Staff received the training and support they needed to perform their roles. Staff were encouraged to become specialists and support other staff with their learning.

People told us they were confident that any concerns they raised would be listened to. The provider made adjustments where necessary to ensure information was accessible to people.

The provider had introduced electronic care plans and call monitoring systems over the summer of 2019. They were still developing systems to ensure the call monitoring information was used effectively. We have made a recommendation about this area.

There was a clear vision and plan for the future of the service. Staff and people who used the service spoke highly of how the organisation was run. Audits were in place, but they did not always demonstrate that the quality of records had been reviewed. We have made a recommendation about this.

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.

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 (report published December 2016)

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.