Background to this inspection
Updated
24 February 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.
This inspection took place on 18 November 2014. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to ensure that the registered manager would be available.
Two inspectors and an expert by experience with an understanding of older people undertook this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We checked the information that we held about the service and the service provider. This included previous inspection reports and statutory notifications sent to us by the registered manager about incidents and events that had occurred at the home. A notification is information about important events which the service is required to send us by law. We used all this information to decide which areas to focus on during our inspection.
We observed care and spoke with people and staff. We also spent time looking at records including four care records, three staff files and other records relating to the management of the service. We contacted local healthcare professionals who had involvement with the service, to ask for their views.
On the day of our inspection, we met with eight people using the service and five relatives. We spoke with the registered manager, the estates manager and three care assistants. After the inspection, we spoke with three people and received feedback from a healthcare professional.
This service was previously inspected on 20 November 2013 and there were no concerns.
Updated
24 February 2015
The inspection took place on 18 November 2014 and was an announced inspection.
Caremark provides personal care services to an extra care housing scheme run by Hanover Housing Association. Extra care housing is housing designed with the needs of frailer, older people in mind and with varying levels of care and support available on site. People had their own self-contained flats, their own front doors and had individual tenancy agreements. There was a restaurant on site, managed by another organisation, that provided meals for people, if they chose not to prepare their own meals. People live independently in their own flats and care calls are provided during the hours of 7 am and 10 pm. A sleep-in carer is available overnight for emergencies. The 33 flats are equipped with alarms to alert staff to emergencies between care calls. At the time of our visit, there were 32 people living at the service and one vacant flat.
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 felt safe living at the service and they could wear personal alarms if they chose to, to alert staff when they needed support. Assessments of risk were undertaken and plans in place to manage them. Accidents and incidents were dealt with in a timely fashion and recorded appropriately. Staff knew what action to take if they suspected abuse and had received safeguarding training. Arrangements were in place in the event of an emergency and regular fire drills took place. The provider had calculated the levels of staff required to ensure that people’s needs were met. The majority of people managed their own medicines, but if needed, staff would assist people to take their medicines. Staff had received training in the administration of medicines.
There was a restaurant on site and people had sufficient to eat and drink throughout the day. Some people preferred to prepare and eat their meals in their flats. People had access to healthcare services and professionals and were supported to maintain good health. Staff received effective support at induction and ongoing supervision, appraisal and training. All staff were qualified to at least Level 2 in a National Vocational Qualification in Health and Social Care. Staff understood their responsibilities under the Mental Capacity Act (MCA) 2005 and put their knowledge into practice.
People were cared for by staff who knew them well and positive, caring relationships had been developed. The service supported people to express their views and made arrangements to meet people’s individual requirements. People were treated with respect and their privacy and dignity was promoted. They were encouraged to do things for themselves and to be as independent as possible.
There was a range of organised activities available at the service and people were also engaged in hobbies that were of interest to them. Some people attended day centres. People received care that was personalised to them and care records detailed people’s preferences and the support they needed. Complaints were dealt with effectively and people knew how to raise any issues or concerns they might have. Tenants’ meetings were held every month and the registered manager participated in these meetings.
People were asked for their views about the quality of the service they received and relatives were also invited to feed back their views. The results overall were positive. There were robust audit systems in place to measure the quality of the service delivered. The registered manager worked with other organisations to provide a continuum of care. Staff were positive about their work and felt supported by the registered manager. They knew what action to take if they had any concerns. There were regular staff meetings and staff were kept abreast of current developments at the service. The registered manager was actively involved in the service and felt supported by the senior managers at Caremark. The service is in the process of changing providers and the staff felt positive about the future.