Clarendon Home Care

Updated 8 April 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 team consisted of two inspectors and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Clarendon Home Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 17 February 2022 and ended on 23 February 2022.

What we did before the inspection

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 also reviewed the intelligence we held about the service such as statutory notifications and information received from people. 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 telephone and video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.

We spoke with 18 people who used the service, six relatives and eight staff members including the registered manager, a director and operations manager.

We reviewed a range of records. This included people’s care records. We looked at and reviewed multiple documents submitted by the provider. These included policies and other information relevant to the running of the service.

Updated 8 April 2022

About the service

Clarendon Home Care is a domiciliary care service and is registered to provide personal care and support to people in their own homes. 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, 82 people were receiving personal care and support.

People’s experience of using this service

There was a continued breach of regulation in relation to staffing. We received mixed feedback about staff punctuality and the amount of time they spent with people when providing care. People and their relatives commented, “Sometimes they are late by half an hour to one hour”; “Other carers are erratic and turn up an hour to two hours late”; “Staff can be abrupt as they are in a hurry.” Other comments included, “Usually the carers are on time”; “Generally, it’s not a problem” and “Our regular carer is on time and stays the whole time.”

Systems were in place to monitor the quality of care people received. However, the electronic system used to monitor staff attendance on their calls did not always work as intended. Despite this, there had not been any missed calls. The registered manager and provider were aware of the problems and told us they were working to resolve the issues.

People felt they were safe with the care and support provided. Comments included, “I feel completely safe and well looked after by them”; “The care is 100% safe”, “I’m OK with the carers” and “[Carers] know me and my needs. I feel safe with them. They hoist me and it’s done safely”.

People’s needs were met. People told us, “I definitely get the care I need”; “Staff have been fantastic” and “They make sure [person] is cared for well”. Staff knew how to identify and report abuse and were trained in safeguarding of vulnerable people. Risk assessments and management plans were in place which enabled staff to provide care safely. Safe recruitment checks were undertaken to ensure suitable staff were employed at the service. People received the support they needed to take their medicines safely. Staff knew how to minimise the risk of infection when providing care.

The majority of relatives, people using the service and staff were happy with the management of the service. People were asked to provide feedback about the service, although they said opportunities to do so were limited at the height of the COVID-19 pandemic. Audits were carried out to monitor and improve the quality of the service.

Accidents were recorded and monitored and discussed with staff to minimise a re-occurrence. The provider worked in partnership with other professionals and agencies to meet people's care needs.

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 requires improvement (published on 22 December 2020) and there was a breach of regulation. The provider also completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the registered manager had increased oversight of staffing and quality assurance processes to ensure people received the care they needed. Despite the improvements made since our last inspection, more work was required to ensure adequate staffing levels and consistency in the delivery of care.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only. This inspection was also carried out to follow up on action we told the provider to take at the last inspection.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

At this inspection we identified a continued breach in relation to ensuring sufficient suitably qualified staff were deployed to meet the needs of people using the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.