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Inspection carried out on 10 June 2021

During an inspection looking at part of the service

About the service

Caremark (Coventry) is a domiciliary care agency which provides personal care to people in their own homes. At the time of our inspection the service supported 234 people living in Coventry and Warwickshire. 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.

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

People and relatives spoke positively about the service they received. People received personalised care which was responsive to their individual needs. Staff had a good understanding of the care and support people needed and provided this with care, commitment, kindness and compassion.

Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice. Risks to people were assessed and regularly reviewed. Staff understood the actions needed to minimise the risk of avoidable harm including the prevention of avoidable infection. Staff were trained in medicine management and supported people to take medicines safely.

Safe recruitment practices were followed, and appropriate checks completed to ensure that only suitable staff were employed. There were sufficient numbers of trained, experienced staff to meet people's needs.

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.

There was a system of ongoing monitoring through audits and spot checks to review the quality of the service provided.

People, staff and relatives expressed confidence in the management team and felt the service had a clear management structure and an open and supportive culture.

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 03 March 2020).

Why we inspected

We carried out an announced comprehensive inspection of this service on 10 January 2020 and we identified improvements were needed.

We undertook this focused inspection to check improvements had been made and sustained. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service changed from Requires Improvement to Good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 10 January 2020

During a routine inspection

About the service

Caremark (Coventry) is a domiciliary care agency providing care and support for people living in their own homes. It is a franchise of Caremark, a national organisation supporting a large number of local care companies. Caremark (Coventry) supports children, younger adults and older people with diverse needs

including, dementia, learning disabilities, sensory impairment, physical disabilities, drug and alcohol misuse and eating disorders. At the time of our inspection approximately 260 people received care and support from this service.

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.

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

Most people felt safe with staff who visited them and were satisfied with the way in which their care and support was provided. However, some people and relatives were concerned care calls did not take place at the times they expected, from staff they knew. Action was being taken to address this. Staff knew how to

keep people safe and had the time they needed to ensure people's needs were met safely. People told us they received their medicines as prescribed. However, records completed by staff to confirm this required improvement.

The providers quality monitoring systems and processes were not consistently effective. Action was planned to address this. Feedback from people, relatives and staff had been used to begin to improve the service and people's experiences. The management and staff team worked in partnership with other professionals

to improve outcomes for people.

People's needs were assessed, and staff understood how to provide care in line with people's lifestyle choices, religious and cultural beliefs. 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.

Staff received comprehensive training and the management support they needed to effectively fulfil their roles. The management team and staff understood and worked within the requirements and principles of the Mental Capacity Act (2005).

People's care was provided by staff who were kind and respectful. Staff knew the people they visited with whom they had developed positive relationships. People's privacy and dignity was upheld and their independence promoted. Staff felt valued and supported by the management team.

Staff understood and used people's preferred methods of communication to ensure people were involved in planning and making day to day decisions about their care. Information about the service was available in a range of different formats. Most care plans informed staff how to deliver personalised care. Complaints were managed in line with the providers complaint procedure.

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 good (published 21 July 2017). Since this inspection, the service has moved premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected: This was a planned inspection based on the previous rating of good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our methodology. If any concerning information is received, we may inspect sooner.

Inspection carried out on 29 June 2017

During a routine inspection

Caremark Coventry is a domiciliary care agency which provides personal care to people in their own homes. At the time of our inspection the agency provided support to approximately 250 people and employed 110 care staff.

At the last inspection on 28 April 2015 the service was rated Good. At this inspection we found the service remained Good.

The office visit took place on 29 June 2017 and was announced. We told the provider before the visit we were coming so they could arrange to be there and for staff to be available to talk with us about the service.

A requirement of the provider’s registration is that they have a registered manager. There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People continued to receive safe care and were supported by staff that knew how to protect them from avoidable harm and abuse. Risks to people’s safety were identified and measures were in place to help reduce these risks. People who required assistance to take their medicines were supported by staff that had received training to do this safely.

There was enough care staff to allocate all the visits people required and to meet people's needs safely. Recruitment checks were completed on potential new staff to ensure they were suitable to support people in their own homes. Staff had regular checks on their practice to make sure they continued to support people safely.

People said staff usually arrived around the time expected and stayed long enough to do everything that was needed without having to rush. People were visited by regular care staff that they knew and who they had formed good relationships with. There had been some recent disruption to the continuity of staff but the provider was confident this had been resolved. People continued to receive support from staff who they said were kind and caring.

The service continued to be effective. Staff received training that provided them with the skills and knowledge to support people’s needs. Staff asked people's permission before they assisted them with any care or support. People's right to make their own decisions about their care were supported by staff who understood the principles of the Mental Capacity Act. When needed, arrangements were in place to support people to have enough to eat and drink and remain in good health.

The service remained responsive to people’s needs and wishes. People were provided with care and support which was individual to them. Staff respected people's privacy and dignity and promoted their independence, which people appreciated. People’s care and support needs were kept under review and staff responded when there were changes in these needs.

People were encouraged to raise concerns and make complaints and were confident these would be responded to. The management team used feedback from people to assist them in making improvements to the service.

Many people told us the service they received from Caremark Coventry was ‘fantastic.’ Staff told us they were very happy in their work and that they received excellent support from an experienced management team who were always available to give advice. Staff were clear about their roles and responsibilities and had regular supervision and observations of their practice to make sure they carried these out safely.

There was a clearly defined management structure which the provider had increased since our previous inspection. The management team provided good leadership; they worked well together and were committed to providing a high quality service to people. Feedback from people and their representatives were continually sought and used as an opportunity for improving the

Inspection carried out on 9 April 2015

During a routine inspection

Caremark Coventry is a domiciliary care agency which provides personal support to people in their own homes. At the time of our visit the agency supported 86 people.

We inspected Caremark Coventry on 9 April 2015. The provider was told we were coming so they could arrange for staff to be available to talk with us about the service.

We last inspected the service in September 2014. After that inspection we asked the provider to take action to make improvements in how risks associated with people’s care were managed, for example, pressure area management. The provider sent us an action plan to tell us the improvements they were going to make. At this inspection we found the required improvements had been made and the provider was meeting their legal requirements.

The service has 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 and their relatives told us they felt safe using the service. Staff were trained in safeguarding and understood how to protect people from abuse. There were processes to minimise risks to people’s safety; these included procedures to manage identified risks with people’s care and for managing people’s medicines.

Managers and care staff understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles.

People mainly had consistent care workers who arrived on time and stayed the agreed length of time. There were enough suitably trained staff to deliver effective care to people. People told us staff were kind and caring and had the right skills and experience to provide the care and support they required.

Care plans and risk assessments contained relevant information for staff to help them provide the personalised care people required. People were able to share their views and opinions about the quality of the service they received. People knew how to complain and information about making a complaint was available for people. Staff were confident they could raise any concerns or issues with the managers, knowing they would be listened to and acted on.

The provider and managers were dedicated to providing quality care to people. Staff and people who used the service found them open, approachable, and responsive. There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through regular communication with people and staff, checks on records, returned surveys and a programme of checks and audits.

Inspection carried out on 23 September 2014

During a routine inspection

When we visited Caremark (Coventry) we spoke with the provider, the manager and a supervisor working in the office. Prior to the office visit we spoke with six people who used the service and five care workers by phone.

We gathered evidence against the outcomes we inspected to help answer our five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff who supported them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

We saw people�s care had been arranged according to their personal needs.

Staff understood their responsibility for ensuring people who used the service were safeguarded from abuse.

We found there was a process in place for managing risks associated with people�s care. We could not be certain that all risks associated with peoples care were sufficiently managed to ensure people remained safe and well.

Some people who used the service were unable to move around without assistance. There was information in care plans for staff about how to move people safely. People told us care workers were competent in using equipment, including a hoist.

All the people we spoke with said they felt safe with their care workers.

We found staff completed the training required to work with people in a safe way.

Is the service effective?

People told us they had been involved in planning their care and the care they received met their needs.

People said care workers arrived around the time expected and stayed long enough to do everything they needed.

Staff we spoke with said they were allocated regular clients and were allocated sufficient time to carry out all the tasks required.

There was no information about pressure area care in the care plans we looked at so we could not be certain the service was effective in managing the needs of people at risk of developing pressure ulcers.

We saw staff had their practice observed to make sure they provided care and support in line with the provider's policies and procedures.

Is the service caring?

Care plans contained information about people�s likes and preferences. This made sure people received care in a way they preferred.

People who used the service indicated the carers were kind and understanding. Comments from people included, �They are brilliant, very friendly, we sit and talk and have laugh.�

People told us care workers were polite and respected their privacy. One person told �They are always polite and very respectful.�

We asked people of care workers treated them in the way they liked. Comments from people included, �They don�t rush me at all. It�s a very relaxed atmosphere.�

Is the service responsive?

People told us they had been asked for their views and opinions during assessments and reviews and any changes were recorded and acted on.

People told us the service was flexible and responded to requests to change call times to accommodate appointments.

Staff we spoke with said there was an �on call� system. We were told, �I have phoned it a couple of times and not had a problem. They either answer it or get back to you.�

People told us that concerns were listened to and acted on.

Is the service well led?

The service had a clear management structure in place and staff spoken with understood their role and associated responsibilities.

We found the service had a quality assurance system in place. This included reviews with people who used the service, telephone conversations and staff spot checks.

Staff received regular observed supervisions to make sure they worked in line with policies and procedures.

The service had auditing procedures in place to make sure staff provided care to people as recorded in their care plans and worked in line with the provider's procedures.

People who used the service told us they were satisfied with the service they received. Comments from people included,

�I am happy with my carers. Nothing is too much trouble.�

�I have had several home care agencies and this is the best by far.�