The inspection took place on 6, 7 and 12 September 2016 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be present.Caremark (Plymouth) is a franchise of the Caremark Group which has 84 offices in the UK and nine offices overseas (Ireland and Malta). Caremark (Plymouth) provides personal care in people’s homes to adults within Plymouth and surrounding rural areas. On the day of the inspection Caremark (Plymouth) was providing personal care support to 141 older people including those with physical disabilities, autism, sensory impairments, mental health needs and people living with dementia.
The service had 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 2008 and associated Regulations about how the service is run.
People were protected from avoidable harm and abuse because staff knew what action to take if they suspected someone was being abused mistreated or neglected. The registered manger had a good understanding of local safeguarding procedures and had worked in collaboration with the local authority in the past, when safeguarding alerts had been raised.
People had risk assessments in place to help ensure they were protected and kept safe. The registered manager was taking steps to review people’s care records to ensure risk assessments were in place relating to people’s healthcare needs. Staff were protected by a lone working policy and the provider had an emergency contingency plan in place, to help in the event of adverse weather or staffing difficulties.
People were supported by sufficient numbers of staff to keep them safe and meet their needs. Staff were recruited safely, to ensure they were suitable to work with vulnerable people. People told us, overall staff arrived on time, but some had experienced delays. The registered provider told us this was an area they were continually trying to improve by listening to people’s feedback. Staff said they had adequate travelling time, and told us if they ever felt that they did not, they were able to raise this and action would be taken to make improvements. People were protected by the spread of infection and people told us staff followed infection control practices, and that their homes were always left clean and tidy. People’s medicines were managed safely, staff received training and people had care plans in place to provide guidance and direction as to how they would like their medicines to be administered.
People received care from staff who had undertaken training to be able to meet their needs. People were positive about the staff’s ability to meet their needs. Staff were complimentary of the training and support they received. The registered manager and deputy manager were passionate about ensuring staff were trained to a high standard. People’s consent to their care and support was sought. Staff had a good understanding of the Mental Capacity Act 2005 (MCA). People were supported with their nutrition and if there were concerns that a person was not eating and drinking enough, action was taken. People were supported to access healthcare services to maintain their health and wellbeing.
People told us they received support from kind and caring staff. People were supported by a small group of staff which helped to ensure continuity of care and develop personal relationships. Staff spoke fondly of the people they supported and told us they liked to go the extra mile. People were involved in decisions relating to their care and support and people told us their privacy and dignity was respected. People were cared for at the end of their life, and staff showed compassion for people’s families.
People had a pre-assessment before joining the agency to help ensure the service could meet their needs. People received personalised care, and had care plans in place to provide guidance and direction to staff. This helped to ensure the support they received reflected their wishes and preferences. People’s care plans were reviewed to ensure they were reflective of their up to date care needs. People’s independence was promoted and staff took opportunities to encourage people to do as much for themselves as possible. People’s complaints were listened to, investigated and used to improve the service.
There was a strong management team, who were passionate about delivering a quality service. Staff felt motivated and well supported. People were asked for their views about the service. There was an open, inclusive and empowering culture within the service. There were systems and process in place so the registered manager could assess the ongoing quality of the service. The managers were open and honest, they responded professionally and promptly to the Commission and external agencies when required.