We carried out a review of the data available to us about Caremark (West Oxfordshire & Cherwell) 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 Oxfordshire & Cherwell), you can give feedback on this service.
Caremark West Oxfordshire and Cherwell provides a domiciliary care service to enable people living in Oxfordshire and the surrounding areas to maintain their independence at home. There were 110 people using the service at the time of the inspection, who had a wide range of physical and health care needs. The CQC only inspects services where people receive personal care which is help with tasks related to personal hygiene and eating. Where services offer personal care, we also consider any wider social care provided.
People's experience of using this service
People told us staff were caring and kind. Staff's commitment and knowledge enabled people to receive care from staff who knew them well.
The registered manager and staff strived to provide safe care and support. The registered manager worked with GPs and other healthcare professions to ensure the service responded to people's changing needs safely and effectively. People's care was personalised and matched their needs, which promoted their well-being and improved their quality of life.
The registered manager continually looked for ways to improve people's lives. Staff culture was positive, and the team was caring. This had resulted in the provision of compassionate and personalised care. The service had a clear management and staffing structure in place. Staff worked well as a team and had a sense of pride working at the service. The provider had quality assurance systems in place to monitor the quality and safety of the service.
People received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff fully understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.
Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.
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 (published 23 March 2017).
Why we inspected:
This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care.
Further inspections will be planned for future dates.
Caremark (West Oxfordshire and Cherwell) provide a domiciliary care service to vulnerable adults to help them to live as independently as they can within their own homes.
At our last inspection on 10 March 2016 we found medicines were not always managed safely, medicine records were not always complete. This was a breach of Regulation 12 Health and Social Care Act (Regulated Activities) Regulations 2014. We also found the provider did not have effective systems in place to ensure the quality of the service was monitored and improved to ensure the regulations were met. This was a breach of Regulation 17 Health and Social Care Act (Regulated Activities) Regulations 2014. In addition mental capacity assessments had not been carried out in line with the Mental Capacity Act 2005. This was a breach of Regulation 11of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014.
At this inspection on 23 March 2017 we found the provider had made significant improvements to address our concerns.
People received their medicines as prescribed. Medicines were safely managed and medicine records were accurately and consistently maintained.
Staff understood the Mental Capacity Act 2005 (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected. Capacity assessments were in place.
The service had systems to assess the quality of the service provided. Learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.
There was 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.
We were greeted warmly by staff at the service who seemed genuinely pleased to see us. The atmosphere in the office was open and friendly.
People told us they were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.
People were supported by staff who were knowledgeable about people’s needs and provided support with compassion and kindness. People received high quality care that was personalised and met their needs.
Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff were aware of people’s needs and followed guidance to keep them safe.
There were sufficient staff to meet people’s needs. Staffing levels and visit schedules were consistently maintained. People told us staff were mostly punctual and they had not experienced any missed visits. However, some people told us they were not always informed of changes to visit times or rotas. The provider followed safe recruitment procedures and conducted background checks to ensure staff were suitable for their role.
Most people told us they were confident they would be listened to and action would be taken if they raised a concern. The service sought people’s opinions through regular surveys and telephone monitoring calls.
Caremark (West Oxfordshire and Cherwell) provide a domiciliary care service to vulnerable adults to help them to live as independently as they can within their own homes.
We had previously carried out an announced comprehensive inspection of this service on 23 July 2015. A breach of legal requirements was found relating to risk assessments not always being complete or in place. We also identified concerns with people not being informed about late visits or changes in information to their visit schedules. In addition, systems used to monitor the service had not identified our concerns and we made a recommendation to the provider to review their audit systems. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation risk assessments and address our concerns relating informing people about changes to visit schedule information and monitoring systems. The provider sent us an action plan in October 2015 stating the action they would take to improve the service to the required standard.
We undertook this full comprehensive inspection to check that they had followed their plan and to confirm that they now met the legal requirements. At this inspection we found actions had been completed and improvements made. However, at this inspection we found other concerns. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Caremark (West Oxfordshire and Cherwell) on our website at www.cqc.org.uk.
People received their medicine as prescribed and staff had been trained to support people with their medicine. However, medicine records did not contain detailed information to protect people from the risk of medicine errors. Records did not always state the medicine, dose or time the medicine should be taken and some records were not accurately maintained.
People were not always protected in relation to the mental Capacity Act (MCA) 2005. We identified the service was not following the requirements of the act and mental capacity assessments had not been completed. Staff demonstrated a good knowledge of the MCA and applied its principals in their day to day work. However, the registered manager did not have a good understanding of their responsibilities relating to the MCA.
The registered manager monitored the quality of service. Regular audits were conducted with the aim of improving the service. However, audits were not always effective. Audits conducted by the registered manager did not identify the concerns we highlighted during this inspection.
There was 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 told us they were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.
Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe.
There were sufficient staff to meet people’s needs. Staffing levels and visit schedules were maintained. People told us staff were sometimes late but they were usually informed. No one told us they experienced any missed visits. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.
People told us they were confident they would be listened to and action would be taken if they raised a concern. We saw complaints were dealt with in a compassionate and timely fashion. The service had systems to assess the quality of the service provided.
Staff spoke positively about the support they received from the registered manager. Staff supervision and meetings were scheduled as were annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.
The service sought people’s views and opinions and acted upon them. Regular surveys were conducted and ‘Telephone Monitoring Calls’ made to allow people to raise issues and concerns.
We identified three breaches of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we have required the provider to take at the end of this report.
We undertook an announced inspection of Caremark (Oxford) Domiciliary Care Agency (DCA) on 23 July 2015. We told the provider two days before our visit that we would be coming. Caremark (Oxford) provides personal care services to people in their own homes. At the time of our inspection 150 people were receiving a personal care service. At our last inspection on 3 October 2013 the service had met all outcomes we inspected against.
There was 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 not always protected from risks. Risk assessments were not always in place when risks to people had been identified. Where risk assessments were in place they did not always provide guidance to staff on how the risk was to be reduced.
Some people experienced late visits and they told us this impacted on their lives. People were concerned they could not always predict when visits would occur. However, no one told us they had experienced a missed visit.
People told us they were informed when visits would happen and who would be visiting. However, these arrangements were often changed without people being informed of the changes. The registered manager was aware of this problem and was taking action to rectify it.
Systems used to monitor the quality of service did not identify our concerns in relation to risk assessments or late visits.
People told us they benefitted from caring relationships with the staff. Comments included; “Staff are excellent, I don’t think I would find better” and “The carers are fantastic”. A relative said “The carers can make my Mother smile”.
Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. Records confirmed the service notified the appropriate authorities where concerns relating to suspected abuse were identified.
Staff had a good understanding of the Mental Capacity Act (MCA) and applied its principles in their work. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity to make decisions were protected.
People told us the service responded to their wishes. Comments included; “The girls are very good, they are very good people, they listen to me and they help me with whatever I need” and “They do what I need doing, when I want it and the way I want it”.
Staff spoke positively about the support they received from the registered manager. Staff supervision records were up to date and they received annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.
Accidents and incidents were investigated and learning from these was shared with staff. This allowed improvements to made. One member of staff said "When we need to be alerted about something the office would send either messages on our mobiles or flash news to make us aware".
We identified one breach of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we have required the provider to take at the end of this report.
We spoke with 22 people and three relatives. Everyone we spoke with was happy with the care provided by the service. One said "I am very pleased. I cannot fault the care". Another said "the carers are a joy". A relative said "I am content my mother is safe and well cared for. I have no worries or concerns". People told us they were involved in their care and that they felt respected. One person said "they are so polite and caring. They help me to be independent".
Everyone we spoke with felt safe and we saw the provider had taken appropriate measures to safeguard people from abuse. All care workers we spoke with demonstrated a good knowledge of abuse and the risks of abuse and they knew who to contact if they suspected abuse was occurring.
We spoke with seven care workers who told us they felt well trained and supported to carry out their role. One said "we get spot checks to support our work and there is always training going on". Another said "this is the best agency I have worked for".
We looked at records and saw that care workers were supported and appropriately trained and that the provider monitored the quality of service it provided.