6 and 16 February 2015
During a routine inspection
The inspection took place on 6 and 16 February 2015 and was announced. 48 hours’ notice of the inspection was given because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available when the inspection took place.
Caremark (Ealing) is a domiciliary care agency that provides a range of care supports to adults and young people living in their own homes. At the time of our inspection the service provided personal care to 33 people.
At the previous inspection of this service on 14 and 21 August 2014 we found that the service was in breach of five regulations. These were in relation to care and welfare of people who use services, safeguarding of people who use services from abuse, staffing, supporting workers, and assessing and monitoring the quality of service provision. During this inspection we found that the provider had taken significant steps to improve the service in order to meet the compliance requirements identified at the previous inspection.
The Service had 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 who used the service and family members were positive about the service that was provided to them.
Records of administration of medicines were limited. Some staff members had not signed to confirm that they had safely administered medicines, and gaps in medicine administration records had not been explained.
People were protected from the risk of abuse. The provider had taken reasonable steps to identify potential areas of concern and prevent abuse from happening. Staff members demonstrated that they understood how to safeguard the people whom they were supporting. Training and information was provided to staff.
Risk assessments were up to date and contained detailed information for staff members in how to manage risk to the person they were supporting. Risk assessments and management plans had been updated to reflect changes in people’s needs.
Staff recruitment processes were in place to ensure that workers employed at the service were suitable. Staffing rotas met the current support needs of people. Staff had access to management support at any time of day or night.
Staff training was generally good and met national standards for staff working in social care organisations. Induction training was refreshed regularly and enhanced by addition training sessions. The provider had recently provided opportunities for staff to undertake qualification training at levels two and three of the Quality Assessment Framework for staff working in social care. Staff members received regular supervision sessions with a manager.
Staff members that we spoke with understood the importance of capacity to consent, and we saw that information about consent was included in people’s care plans. The provider had recently introduced training in respect of The Mental Capacity Act (2005).
Information regarding people’s dietary needs was included in their care plans, and detailed guidance for staff was provided in order to ensure that they met these.
People who used the service and family members were positive about the care that they received. Staff members spoke positively and respectfully about their approaches to care, and the people that they provided care to.
Care plans were up to date and contained detailed information about people’s care needs and how these would be supported. People who used the service and family members were positive about the quality of care that they received. The quality of care was monitored regularly through contact with people who used the service and family members where appropriate.
People who used the service knew what to do if they had a concern or complaint.
The service was well managed. Staff, service users and family members spoke positively about the management, and there was evidence that concerns raised at a previous inspection had been addressed promptly. A range of processes were in place to monitor the quality of the service.
We found that the registered person had not protected people against the risk of unsafe use and management of medicines. This was in breach of regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 12 (f) & (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we have asked the provider to take at the back of the full version of the report.