Archived: Caremark (West Norfolk)

Updated 28 May 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 05 and 12 March 2015. We gave the provider 48 hours’ notice of the inspection.

The inspection was carried out by one inspector.

Before we visited the service we checked the information that we held about the service and the service provider. For example, notifications that the provider is legally required to send us and information of concern that we had received. Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. They did not return a PIR and we took this into account when we made the judgements in this report.

During our inspection we spoke with two people who used the service and two people’s relatives. We also spoke with five staff, including care staff, and the care coordinator. We reviewed records, which included five people’s care records, two staff recruitment records, staff training records, two medicine records and audit and quality monitoring processes.

Updated 28 May 2015

This inspection took place on 05 and 12 March 2015 and was announced. Caremark (West Norfolk) is a domiciliary care agency providing care and support for people, some of whom may live with dementia.

The home did not have a registered manager. 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 felt safe and that staff supported them in a way that they liked. Staff were aware of safeguarding people from abuse. Individual risks to people were assessed by staff, although not all assessments provided guidance to reduce the risk to staff members.

There were enough staff available at most times to meet people’s needs. Staffing levels were high enough most of the time to ensure staff members arrived on time and were not rushed, although there remained instances where people had to wait for their care.

Most of the required recruitment checks had been obtained for new staff, but the provider did not ensure all actions were taken to make sure new staff were suitable to work with people.

Medicines training was not always robust enough to provide staff with the necessary skills to administer medicines safely.

Staff members only received induction training, which did not always ensure they had the knowledge or skills to meet all care needs. Staff were not provided with effective supervision and support.

Staff members did not understand the Mental Capacity Act. There was no guidance for staff about how to support people if they were not able to make decisions for themselves.

There was enough information available for staff members to contact health care professionals on behalf of people.

Staff were caring, kind, respectful and courteous. Staff members listened to people’s preferences and involved them and their relatives in their care.

People’s needs were responded to well and care tasks were carried out as required by staff. Care plans, however, did not contain enough information to provide new staff with guidance about how to meet people’s needs.

A complaints procedure was available and action was taken to respond to complaints made.

Staff members worked in an improving team environment, with support from office staff.

Managerial and provider support had not been effective in ensuring the service was well led or well run. There was no manager at the service and there had been no registered manager since June 2013. There had been difficulties with contacting the provider of this organisation and obtaining information about the leadership and management of the service.

The service did not properly monitor care and other records to assess the risks to people and ensure that these were reduced as much as possible.

We have made a recommendation about staff supervision.