Charmes Care

Charmes Care is a domiciliary care agency which provides support and personal care to people living in their own home. 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 our inspection visit commenced, 35 people were receiving a regulated activity from the service. When we completed our inspection activity, due to planned changes to the service this had reduced to 29 people.

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

People's care plans were up to date and contained person centred information. However, not all risk assessments for people contained sufficient information which would enable staff to understand how to mitigate the risk of harm. This placed people at risk of not receiving the appropriate care and treatment they required. We have made a recommendation about this in the report.

Staff had received training in safeguarding people, and they knew how to report any signs of abuse, or any accidents and incidents. However, we found safeguarding concerns were not always recognised by the management team or shared with CQC and the local authority as required.

Most people and relatives we spoke with, felt staff were kind and caring but were dissatisfied with the service they received. This was in relation to the time of day they received their visit, the length of the visit and communication with the management team.

Staff did not always feel supported in their role and felt they were not listened to if they raised concerns. Travel time was not always allocated and staff told us they were often rushed or unable to meet all of people’s needs within the time given. This impacted on the culture of the service.

Staff had completed training in the safe administration of medicines and had their competency assessed to do so safely. People were happy with how they were supported around their medicines. However, improvements were needed to medicine records to ensure staff had the information they needed to administer ‘as and when required medicines’, and there was sufficient time in between doses.

There were quality assurance systems in place based on a range of audits. However, we found these were not always effective. They had not identified all the concerns we identified during this inspection.

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.

People told us care staff were kind and caring and they felt safe with them. Staff respected people's right to privacy and dignity and promoted independence.

Staff felt they could contact the management team and they were informed of any important information or changes.

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 requires improvement (published 26 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This inspection was prompted by the previous rating of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Charmes Care on our website at www.cqc.org.uk.

Enforcement

We have identified breaches of regulation in relation to, safeguarding, staffing and governance at this inspection. We have made a recommendation about risk management.

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.

Charmes Care is a domiciliary care agency which provides support and personal care to people living in their own home. Not everyone using Charmes Care received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection 39 people were receiving a regulated activity from the service.

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

People and relatives told us the care received was safe. However, there were mixed views in relation to the care calls being met as per arrangements.

Risk assessments that were in place were clear, detailed and comprehensive, however, we identified specific risk assessments had not consistently been completed when required. This was immediately addressed by the registered manager and senior management team.

People told us, where staff supported them with medicine this was done safely. However, some improvements were required in relation to ensuring people received their medicine as prescribed.

There were some quality monitoring processes in place, but these had not always been effective as they had not enabled the provider to identify the issues we found.

People were supported by staff who knew them well and had been safely recruited. Staff wore appropriate personal protective equipment and followed government guidance on COVID-19.

All people and relatives spoken with were confident in the staff’s abilities and thought staff had the right skills to look after them. New staff completed a comprehensive induction to their role prior to commencing employment and ongoing training and supervision was provided.

Staff supported people to access healthcare professionals when they needed them and worked alongside health and social care professionals to ensure a joined-up approach to people's care.

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.

People told us staff were kind and caring and that people felt safe with staff. Staff respected people's right to privacy and dignity and promoted independence.

People and their relatives knew how to complain and were confident their concerns would be dealt with.

Care plans were person-centred for staff to know each person on an individual level. People told us they were provided with person-centred care.

The management team kept in regular contact with people and the registered and deputy manager often visited people in their homes, checking if they were happy with the service they received and if any changes were needed.

The management team were open and transparent and understood their regulatory responsibilities.

The service worked well with other partners, organisations and commissioners.

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 the service under the previous provider was Good, published on 15 January 2019.

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.