Caremark (West Berkshire and Reading)

Updated 6 September 2022

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 2008.

Inspection Team

This inspection was carried out by one inspector 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 care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection visit. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 17 August 2022 with our site visit, followed by a telephone survey by the Expert by Experience of people who used the service, completed on 22 August 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including notifications received from the provider. The law requires providers to send us notifications about certain events that happen during the running of a service. We sought feedback from the local authority and professionals who work with the service. We reviewed the provider’s website. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used this information to plan our inspection.

During the inspection

We contacted 23 people and spoke with five people who use the service and ten relatives about their experience of the care provided. We spoke with 12 members of staff, including the registered manager, two field care supervisors, an office administrator and eight care support workers.

We reviewed a range of records. This included nine people’s care records, medication records and daily notes. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed, including the provider’s policies, procedures, quality assurance audits and field care supervisor’s planners. We also examined staff training, supervision and competency records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with four community professionals who visit the service and two other relatives.

Updated 6 September 2022

About the service

Caremark (West Berkshire and Reading) is a domiciliary care agency providing care and support to people living in their own homes. It provides a service to older adults, younger adults, people living with dementia, physical disability, learning disability, sensory impairments, eating disorders, mental health diagnoses and substance misuse. Not everyone who uses the service receives personal care. CQC only inspects where people receive personal support with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 40 people were receiving personal care delivered by 22 staff.

People’s experience of using this service and what we found

People were protected from the risk of avoidable harm by staff, who understood how to safeguard people from discrimination, neglect, and abuse. Enough staff were deployed, with the right mix of skills to deliver care and support to meet people’s needs. Staff assessed risks to people’s health and well-being, which were managed effectively. People mostly experienced good continuity and consistency of care from regular staff who knew them well and how they wished their care to be delivered. Staff had been recruited safely in accordance with regulations. People received prescribed medicines safely from staff who had their competency to do so regularly assessed. Staff had raised concerns and reported incidents, to protect people from similar events in the future. We were assured that staff followed good infection control and safe food hygiene practices.

The service was well managed by the registered manager who had developed the field care supervisors and care coordinator into an effective management team that worked well together. The management team supported staff to deliver care based on best practice through a system of competency checks, supervision, appraisal and staff meetings. The registered manager understood their legal responsibility to be open and honest with people when something goes wrong. The management team successfully operated systems to review the quality and safety of the service. The registered manager encouraged feedback from people and staff to drive continuous improvement in the service. Staff had developed positive working relationships with community health care professionals, which ensured people’s changing needs were met with the appropriate care and treatment.

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 and update

The last rating for this service was requires improvement (published 27 January 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do to improve and by when. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced responsive inspection of this service on 8 and 9 December 2020. Three breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, good governance and their compliance with their duty of candour.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-Led, which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caremark (West Berkshire and Reading) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.