Archived: Karemill Homecare Ltd

Updated 10 June 2022

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.

Inspection team

The inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure the registered manager would be available to support the inspection.

What we did before inspection

We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.

Inspection activity started on 3 May 2022 and ended on 16 May 2022.

We were unable to gain feedback from the people who were using the service as they were unavailable. In order to obtain people’s experience of care provided by the service we spoke to two relatives. We spoke with three members of staff including the registered manager, a care worker and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included two people’s care records, risk assessments and daily notes. We looked at three staff files in relation to their recruitment, training and supervision. A variety of records relating to the management of the service including policies and procedures were reviewed.

Updated 10 June 2022

About the service

Karemill Homecare Limited is a domiciliary care agency providing personal care to people in their own homes or flats. The service provides support to people over and under the age of 65, people living with dementia, people living with a physical disability and people living with a sensory impairment.

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. At the time of our inspection there were six people using the service, of which two people were being supported with the regulated activity of personal care.

People’s experience of using this service and what we found

People using the service were unavailable to provide us feedback about the care and support they received. We spoke with their family members who were able to provide us with their experience of the care provided.

People had care plans in place. However, these did not include information advising of people’s likes, dislikes, preferences or health and medical history. Information was not recorded clearly to guide staff to provide care and support which was person centred. Risk assessments were limited in their detail and did not provide clear information to direct staff to support people safely.

The quality assurance system was not being used to effectively identify where improvements were required to make change and support development of the service.

Relatives spoke positively about the care provided. Relatives told us the staff team were familiar and made them feel safe. One relative said, “Knowing the [staff] means we can trust them.” Another relative said, “We were initially anxious with receiving care but now rely on the [staff] and the support provided.”

An induction process was in place to support newly recruited staff and prepare them for their role. Staff had received training to provide them the skills and knowledge required for their role. Staff felt supported by the registered manager.

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. Relatives told us the [staff] were respectful in their work and sought permission before providing care and support.

Relatives told us they found the registered manager to be approachable and felt confident they would address any concerns should these arise. Relatives told us the staff were friendly and caring.

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 registered with us on 6 April 2021 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration.

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to the care planning and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.