Caremark East Hertfordshire and Broxbourne

Updated 31 July 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

One inspector and an inspection manager carried out this inspection.

Service and service type

Caremark East Hertfordshire and Broxbourne 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 told the provider the two days before our office visit that we would be inspecting. We did this because wanted to contact people who used the service for feedback on the service provided before we visited the office. We also we wanted to make sure that the registered manager was available to speak with us.

What we did before the inspection

We reviewed information we had received about the service since registration with the CQC. We sought feedback from the local authority and professionals who work with the service. 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

We spoke over the telephone with two people who used the service about their experience of the care provided. We received emails about the quality of the service from another person, four relatives and six external care professionals. These included two commissioners of the service, a social worker, a senior social worker and a representative of a local authority contracts monitoring team.

During our visit to the service’s office we spoke with two care workers, a field care supervisor, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with a regional manager for Caremark.

We reviewed a range of records. This included sampling seven people’s care records. We looked at two staff files in relation to recruitment, supervision and training. We also looked at a variety of records relating to the management of the service, including audits and quality assurance reports, and minutes of staff meetings.

After the inspection

Following our visit, the nominated individual sent us further information about the service provided, and feedback they had received.

Updated 31 July 2019

About the service:

Caremark East Hertfordshire and Broxbourne is a domiciliary care agency that provides personal care to adults with physical disabilities and older people in the local area. 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 our inspection 26 people were receiving the service.

People’s experience of using this service:

People received outstanding care and support by a staff team that were committed, passionate and knowledgeable. Staff provided people’s care in a very person-centred way. Staff were creative in helping people to express their views and people were consulted about all aspects of their care and support.

People felt safe receiving the service and were protected from avoidable harm by a staff team trained and confident to recognise and report any concerns. Potential risks to people were assessed and minimised and people received their medicines at the right times. Staff had the time to ensure people’s needs were met safely, and in a way that suited them. People received care from a small team of staff who were well trained and exceptionally well supported. Staff worked well together and with external care professionals to ensure people received the care and support they needed.

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. People were involved in making decisions about their care and support. Where people needed additional support to make decisions, staff referred people to external advocates.

Staff were genuinely interested in and knew people extremely well. People’s care plans were detailed and provided staff with comprehensive guidance on how to meet people's needs. Staff were skilled at supporting people while minimising triggers that may cause people anxiety. Where it was part of the planned care, staff supported people to access the community, such as shop, churches and restaurants.

Staff were caring, compassionate and thoughtful, which reflected the provider’s values of person-centred care. Staff treated people with the utmost respect and had embedded privacy and dignity into their working practice. There was a strong recognition that people were individuals. Staff spoke passionately about providing people with excellent, person-centred care and showed real empathy for people.

The provider and registered manager were experienced, skilled leaders who were committed to involving people, relatives, staff and other stakeholders in the development of the service. Audits, quality monitoring checks helped drive forward further improvements in the service. We received positive feedback about the way the service was managed. Everyone said the provider, registered manager and staff were approachable and accessible.

The service had developed strong links with the local community and looked for ways to increase people's awareness of care and related topics such as dementia. The provider and registered manager looked for ways to continuously improve and develop the service. Staff were proud to work for the service and worked in partnership with external professionals.

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

Rating at last inspection: This service was registered with us on 24 May 2018 and this is the first inspection.

Why we inspected: This was a planned inspection based on the date of the provider’s registration with the CQC.

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.