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Inspection carried out on 3 July 2019

During a routine inspection

About the service:

Carers for You Limited is a domiciliary care agency. The service is also known as Caremark (Harrow). The agency provides personal care to people living in their own homes in the community. There were approximately 55 people using the service at the time of our inspection. The provision of personal care is regulated by the Care Quality Commission.

People’s experience of using this service:

People and their relatives told us they were satisfied with the care they received. They stated that staff were well trained, did their jobs well and people felt safe when cared for by staff.

Risks to people’s health and wellbeing had been assessed and this included risks of falling, pressure sores and certain medical conditions people had. Risk assessments contained guidance for minimising risks to people.

The service had a safeguarding policy and procedure. Staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to, or at risk of abuse.

Staff had received medicines administration training and knew how to administer medicines safely. Regular checks and audits of medicines administration records (MARs) were carried out to ensure that errors were identified and promptly responded to.

Staff were safely recruited, and essential pre-employment checks had been carried out. There were enough staff to attend to people’s needs.

The healthcare needs of people had been assessed and staff worked closely with healthcare professionals to meet the needs of people.

Staff encouraged people to have a healthy diet where this was part of their contracted responsibilities. They were aware that if there were significant fluctuations in people’s weight, they should alert their manager, relatives and professionals involved.

Staff had received appropriate training and they had the knowledge and skills to support people. The registered manager and senior staff carried out regular supervision, annual appraisals and random spot checks to ensure that staff were able to carry out their duties.

Staff understood their obligations regarding the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff were caring and treated people with dignity and respect. They had received training on ensuring equality and valuing diversity and respecting the human rights of people. Feedback from people and their relatives indicated that staff formed positive relationships with people.

People’s care needs had been fully assessed and staff were knowledgeable regarding people’s needs. The service provided people with person-centred care and support that met their individual needs and choices. People said their preferences and choices had been responded to.

The service had a complaints procedure and people and relatives were aware of who to complain to. The service took complaints seriously. Complaints recorded had been promptly responded to.

The service was well managed. Morale among staff was good. Management monitored the quality of the services provided via regular checks and audits. The results of a recent satisfaction surveys indicated that people and their representatives were satisfied with the care and services provided. Suggestions made for improving the service had been responded to.

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 was Good (published on 15 March 2017).

Why we inspected:

This was a scheduled planned comprehensive inspection.

Follow up:

We will continue to monitor the service through the information we receive.

Inspection carried out on 13 February 2017

During a routine inspection

We undertook this announced inspection on 13 February 2017. Carers for You Limited is registered to provide Personal Care services to people in their own homes. The services they provide include personal care, housework and assistance with medicines.

At our last comprehensive inspection on 3 March 2016 the service we rated the service as “Requires Improvement”. We found two breaches of The Health and Social care Act 2008 (Regulated Activities) Regulations 2014. The first breach was in respect of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to safe care and treatment. We noted that the records of some people had unexplained gaps in their medicine administration charts (MAR). This indicated that there was no documented evidence that these people had received their required medicines. During the inspection on 13 February 2017, the provider demonstrated that they had taken action to comply and the requirement made. We found no gaps in the MAR charts we examined. People told us they had been given their medicines as agreed.

The second breach was in respect of Regulation 17 relating to good governance. The service did not have effective quality assurance systems for assessing, monitoring and improving the quality of the service. This meant that deficiencies in the service provided may not be promptly identified and rectified. During the inspection on 13 February 2017 the provider had the necessary checks and audits for ensuring quality care. These included reviews of care and regular spot checks on care workers. Documented evidence of these was provided.

People who used the service and their representatives informed us that they were satisfied with the care and services provided for people. They informed us that people had been treated with respect and dignity. They stated that people were safe when cared for by the service. There was a safeguarding adults policy and suitable arrangements for safeguarding people from abuse.

There were suitable arrangements for the administration of medicines. Medicine Administration charts were regularly checked by senior staff of the service to ensure that people received their medicines as agreed. The service had an infection control policy. Gloves, aprons and shoe covers were available in the office for care workers. People and their representatives informed us that care workers observed hygienic practices.

Care workers had been carefully recruited. The necessary checks had been undertaken prior to them starting work. New care workers had been provided with a comprehensive induction and training programme to enable them to care effectively for people. They had the necessary support and supervision from senior staff and the registered manager. Teamwork and communication within the service was good. There were sufficient care workers to meet people's needs.

Care workers were caring in their approach and knowledgeable regarding the individual choices and preferences of people. People’s care needs and potential risks to them were assessed and guidance provided to care workers on how to care for people. Care workers prepared appropriate and up to date care plans which involved people and their representatives. People’s healthcare needs were monitored where this was part of the care agreement.

There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Reviews of care had been carried out to ensure that people received appropriate care. The service had a complaints procedure. Complaints and concerns made had been promptly responded to.

People and their representatives expressed confidence in the management of the service. They stated that care workers communicated well with them and kept them informed if they were held up or running late. A recent satisfaction survey indicated that people and their representatives w

Inspection carried out on 3 March 2016

During a routine inspection

We undertook this announced inspection on 3 March 2016. Carers for You Limited is registered to provide Personal Care services to people in their own homes. The services they provide include personal care, housework and assistance with medicines,

At our last inspection on 3 January 2014 the service met the regulation we looked at.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 and associated Regulations about how the service is run.

People and their representatives informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they were safe when cared for by the service. There was a safeguarding adults policy and suitable arrangements for safeguarding people from abuse.

Care workers were caring in their approach and knowledgeable regarding the individual choices and preferences of people. People’s care needs and potential risks to them were assessed and guidance provided to care workers on how to care for people. Care workers prepared appropriate and up to date care plans which involved people and their representatives. People’s healthcare needs were monitored and are workers arranged for them to have appointments with healthcare professionals when needed. Care workers worked well with social and healthcare professionals to bring about improvements in people’s care. This was confirmed by professionals we contacted.

There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Reviews and evaluations of care had been carried out to ensure that people received appropriate care. There were arrangements for the recording, storage, administration and disposal of medicines. We however, noted that there were unexplained gaps in the medicine administration charts (MAR) of people. This omission may put people at risk and we found a breach of regulations in respect of this.

Care workers had been carefully recruited and provided with a comprehensive induction and training programme to enable them to care effectively for people. They had the necessary support, supervision and appraisals from their managers. Care workers were able to attend to people's care needs. Teamwork and communication within the service was good.

People and their representatives expressed confidence in the management of the service. They stated that care workers communicated well with them and kept them informed if they were held up or running late. Care workers were aware of the values and aims of the service and this included treating people with respect and dignity, providing high quality care and promoting people’s independence.

Complaints made had been promptly responded to. Three social care professionals provided positive feedback regarding the management of the service. They indicated that the service was well organised and there was good communication with the service regarding the progress of people.

Audits and checks of the service had been carried out by the registered manager and field care supervisors of the service. These included three monthly spot checks on care workers and three monthly telephone monitoring calls to people who used the service. In addition, the service had three monthly face to face reviews to obtain feedback from people who used the service. We noticed that audits on medication recording were not sufficiently comprehensive as they failed to identify and rectify the deficiencies we noted.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of t