Archived: Caremark (Hounslow)

Caremark (Hounslow) is a domiciliary care agency that provides personal care for people in their own homes. At the time of the inspection eight people were receiving support including a regulated activity in their own homes.

We previously inspected Caremark (Hounslow) on 17 and 18 December 2015 and the service was rated as Requires Improvement with the Safe domain rated as Inadequate. Issues were identified in relation to safeguarding, administration of medicines, recording incidents and accidents, risk assessments, mental capacity assessments, person centred care planning and quality assurance. During the inspection on the 1 September 2016 we saw that improvements had been made across the issues identified.

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

The provider now had processes in place for the recording and investigation of incidents and accidents.

A range of risk assessments were in place in the support folders in relation to the care being provided including ones related to specific health and support issues with guidance for care workers.

The provider had an effective recruitment process in place. There was a policy and procedure in place for the administration of medicines. Care workers were completing Medicine Administration Record (MAR) charts accurately and clearly.

The provider reported any safeguarding concerns to the local authority. People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.

Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.

The provider now had policies and procedures in place to carry out assessments in relation to the Mental Capacity Act 2005.

People we spoke with felt the care workers were caring and treated them with dignity and respect while providing care. Care plans identified the person’s cultural and religious needs.

Detailed assessments of the person’s needs were carried out before the person started to receive care in their own home. Each person had a care plan in place which described their support needs. Care workers completed a record of the care and support provided during each visit.

The provider had a complaints process in place and people knew what to do if they wished to raise any concerns.

The provider now had systems in place to monitor the quality of the care provided and these provided appropriate information to identify issues with the quality of the service.

Caremark (Hounslow) provided a range of services to people in their own home including personal care. At the time of our inspection 10 people were receiving personal care in their home. All of the people using the service were funding their own care.

This was the first inspection of the service since it was registered on 2 April 2015.

At the time of the inspection the manager was in the process of applying to be registered with the Care Quality Commission. 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.

Care workers were providing care to people in their homes while unsupervised before their Disclosure and Barring Service (DBS) check had been received.

The records relating to when medicines were administered by care workers were not accurate.

The provider had generic risk assessments in place but they had not identified possible risks in relation to specific issues for people using the service and had not provided care workers with guidance on how to reduce these risks.

The provider had a process for the recording of incidents and accidents but this was not always followed and information relating to any actions taken was not recorded.

There was a policy and training in relation to the Mental Capacity Act 2005. However, the provider did not ensure appropriate actions were taken when a person using the service had been identified as unable to make decisions about their care.

The care plans did not provide accurate information in relation to the person’s current support needs.

The provider did not have a robust system of audits and checks in place to review the quality of the care and support provided.

There were safe practices in place in relation to recruitment. Care workers had received an induction and training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Care workers also had regular supervision with their manager.

The provider had a good working relationship with General Practitioners (GPs) and other healthcare professionals who provided support for people using the service.

People using the service and relatives felt safe when care was being provided in their homes. They also felt the care workers were kind, caring, treated people with respect and maintained their dignity when providing care.

The provider had a complaints procedure in place and people we spoke with knew how to make a complaint if necessary.

People using the service, relatives and care workers felt the service was well-led.

We found a number of breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safeguarding people, medicines management, recording incidents and accidents, risk assessments, the Mental Capacity Act 2005, accurate care plans and quality assurance. You can see what action we told the provider to take at the back of the full version of this report.