We carried out a review of the data available to us about Caremark (West Berkshire and Reading) 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 (West Berkshire and Reading), you can give feedback on this 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.
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 the service was providing personal care to people living in the Newbury, Thatcham and surrounding areas.
People’s experience of using this service and what we found
Risks to people had been assessed and documented. However, some assessments did not specifically state risks to people or contained misleading information. Although there was no evidence to demonstrate people had experienced harm, the provider could not be assured they had done all they could to mitigate risks associated with people’s care and support.
The service management and leadership was inconsistent and did not always support the delivery of high-quality, person-centred care. Deficiencies identified during our last inspection had not been fully addressed and the provider had not effectively operated processes to ensure compliance with regulations. The registered manager understood the duty of candour and knew the actions to take should something go wrong. However, they had not complied with this duty in relation to a notifiable safety incident.
The provider had promoted a positive culture within the staff group, which was open and inclusive, and encouraged staff to be involved in developing and improving the service. The provider had developed an action plan, incorporating an analysis of lessons learnt to drive improvement in the service. Staff worked in collaboration with community health and social care professionals to promote people’s health and well-being.
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 understood their responsibilities to protect people from abuse and avoidable harm. Enough staff with the required skills and knowledge provided people with safe care. People received their medicines safely, as prescribed, from staff who had completed the required training and had their competency assessed to do so. People were supported to maintain high standards of cleanliness and hygiene, which reduced the risk of infection. Staff followed the required standards of food safety when preparing, serving and handling food.
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 23 October 2019) and there was a breach of regulation. At this inspection enough improvement had not been made and the provider was still in breach of regulation. The service remains requires improvement. The service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We carried out an announced comprehensive inspection of this service on 23 October 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when, to reach compliance with the regulation for "Good governance".
We undertook this focused inspection to check they now met legal requirements. In addition, we had received concerns in relation to the management and safety of the service provided. For these reasons this report only covers our findings in relation to the key questions of safe and well-led, which cover those requirements and concerns.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained the same. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to the safe care and treatment of people, good governance and the registered person’s duty of candour.
You can see what action we have asked the provider to take at the end of this full report.
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.
Caremark West Berkshire and Reading is a home care service providing personal and nursing care to 30 people aged 65 and over, living in their own homes.
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
Medicines were not always managed safely. Medicines audits were not always used effectively to identify and address omissions and errors. People’s medicines administration records were not completed correctly. Important details such as names of medicines, allergies and details of people’s GPs had not been recorded in people’s care documents.
Risk assessments in people’s care plans contained contradictory information. Guidance for staff about how to manage risks for people did not contain enough detail.
Staff recruitment files did not contain evidence of all the necessary checks, in line with legislation.
We made recommendations that the provider review their systems and processes, and regulatory requirements, to ensure all records in relation to medicines management, risk assessments and staff recruitment were accurate and up to date, in line with legislation.
There were systems and processes for managing quality and safety in the service. However, these were not always effective as they had failed to identify the errors and omissions in people’s medicine’s administration records. These systems had also failed to identify the insufficient guidance and contradictory information in people’s risk assessments. In addition, quality assurance processes had not been used effectively as the provider had not identified the omissions in staff recruitment records.
After the inspection the manager put an action plan in place to address these issues.
People were protected from the risk of harm and abuse. There were enough suitably skilled and qualified staff to support people and meet their needs. People were supported by skilled staff with the right knowledge and training.
Staff had developed caring bonds with people and upheld their privacy, dignity and independence. People’s care and support met their needs and reflected their preferences. Staff upheld people’s human rights.
There was a positive, empowering culture in the service. Staff were clear about their roles and responsibilities and felt well supported by the registered manager and senior team.
People were supported to have maximum choice and control of their lives. 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
This service was last inspected on 21 March 2017 and was rated good. At this inspection the service was rated requires improvement.
Why we inspected
This was a planned inspection in line with our published inspection timeframes.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
We identified one breach of regulation 17 (good governance.) You can see what action we have asked the provider to take at the end of this full report.
At the last inspection the service was rated GOOD. At this inspection we found the service remained Good.
Why the service is rated Good:
People continued to receive safe care from the service. Staff were recruited safely and there were sufficient numbers of staff to support people. Medicines were managed safely by staff who had received appropriate training. Risk assessments were completed to enable people receive care with a minimum of risk to themselves or the care staff.
People continued to receive effective care from staff who were trained and supported to have the skills and knowledge to effectively support them. People’s healthcare needs were monitored and advice was sought from healthcare professionals when appropriate. 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 service remained caring and people reported staff were kind and patient. Staff protected people’s privacy and dignity and treated them with respect. People told us they could make decisions about their care.
The service remained responsive to people’s individual needs. Care plans were personalised and identified the preferences of each individual. Complaints were investigated in line with the provider’s policy and used to provide learning opportunities for staff.
The service continued to be well-led. The registered manager promoted an open and transparent culture and wanted to work towards improving the service. People’s views were sought and the quality of the service was monitored. Action was taken when issues were identified and the registered manager worked with staff to develop and improve the service.
Further information is in the detailed findings below.
This inspection took place on 17 March 2015 and was announced. Caremark (West Berkshire and Reading) is a domiciliary care service and at the time of the inspection was providing personal care for 107 people living in their own homes.
At the time of the inspection there was a 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 told us that staff treated them with kindness, dignity and compassion. People also said they were respected and involved in decisions about their care. Most people told us they had been asked for their views on the service. However, some people felt there could be more surveys carried out and two people said they had been told they would receive a visit from the manager to ask their views but this had not happened.
People using the service told us they were happy with the service they received from Caremark (West Berkshire and Reading) and felt safe using the service. There were systems in place to manage risks to people and staff. Staff were aware of how to keep people safe by reporting concerns promptly through procedures they understood well. Information and guidance was available for them to use if they had any concerns.
People’s needs were reviewed regularly and up to date information was communicated to staff to ensure they could provide appropriate care. Staff contacted healthcare professionals in a timely manner if there were concerns about a person’s wellbeing.
The registered manager had a good knowledge of the Mental Capacity Act (2005) and staff understood their responsibilities in relation to gaining consent before providing support and care. New staff received an induction in line with the common induction standards (CIS), training and spent time with experienced members of staff before working alone with people. Staff received refresher training in topics the provider considered essential on a regular basis.
The provider’s recruitment procedures were robust and there was a system to ensure people received their medicines appropriately. The quality of the service was monitored by the registered manager and the service was audited by the provider’s head office. Staff were aware of how to deal with emergency situations and the provider had plans in place to deal with emergencies. This was to ensure people would be cared for in the event of foreseeable emergencies.
Staff felt well supported by the registered manager and provider and said they were listened to if they raised concerns. Staff felt there was an open culture in the service and they were comfortable to approach the registered manager or provider for advice and guidance. Complaints were addressed and action taken according to the provider’s policy.
We spoke with four staff members and the provider. Staff told us that they followed care plans which they felt contained adequate information. Care plans we looked at had been reviewed and were up to date.
Appropriate recruitment checks were carried out and recorded. New staff completed an induction and attended core training.
People who used the service were protected from the risk of abuse. The provider had taken action to respond appropriately when it was suspected that abuse had occurred or was at risk of occurring. People we spoke with said they felt safe using the service and they had confidence in the care workers and their abilities.
There was an effective complaints system. Comments and complaints were listened to and acted on.
The provider had an effective system in place to regularly assess and monitor the quality of service people received.