Caremark (Mansfield & Ashfield)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider demonstrated a proactive and positive culture of safety, underpinned by openness, transparency, and honesty at all levels of the service. Staff were encouraged to raise concerns and felt confident in doing so, knowing that these would be taken seriously, investigated appropriately, and used as opportunities for improvement rather than blame.

There were clear systems in place to identify, report, and learn from safety events. Staff were knowledgeable about when and how to complete incident forms, ensuring that all incidents and near misses were accurately recorded in a timely manner. Senior staff maintained effective oversight by reviewing incident reports daily, allowing for prompt action and escalation where required.

Feedback mechanisms were well embedded within the service. Staff received regular feedback on incidents, including outcomes of investigations and any lessons learned. This supported a continuous cycle of learning and improvement, helping to prevent recurrence and strengthen practice. Where trends or patterns were identified, appropriate changes were implemented, and best practice was shared across the team.

People were supported through safe and coordinated systems of care, with appropriate planning to ensure their needs could be met before services commenced. Pre-assessments were completed by senior staff to confirm that the provider could safely meet people’s needs, supporting effective risk management from the outset.

The provider worked collaboratively with people and healthcare partners to maintain continuity of care. Where appropriate, people had hospital passports in place, which supported effective communication of their needs in the event of hospital visits or admissions. This helped ensure that relevant information was shared promptly and people received consistent, person-centred care across different services.

Staff demonstrated an understanding of the importance of partnership working and involved external healthcare professionals where required. This included liaising with district nurses and continence nurses to ensure people’s changing needs were regularly reviewed and appropriately managed.

Staff had a good understanding of people’s personalised risks and safeguarding needs. Staff were able to clearly describe the specific vulnerabilities of each person they supported, including risks related to communication, health conditions, behaviour, and social situations. This demonstrated that they knew people well and were confident in recognising even subtle changes that might indicate increased risk.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. Where people receive support in their own homes, this can be done through The Court of Protection which is defined as part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed deprivation of liberty within the service. We found that the principles of the MCA were being met and issues were identified quickly. Staff followed the organisation’s procedures correctly and informed the Registered Manager without delay. The Registered Manager demonstrated strong oversight of safeguarding. They assessed concerns promptly, took proportionate action based on level of risk, and made timely referrals to the relevant external agencies, including the local authority safeguarding team, health professionals, and the Care Quality Commission. Lessons learned were shared with staff, which strengthened the service’s safeguarding culture.

People were actively involved in understanding and managing risks in a way that was person-centred and holistic. Care was planned and delivered to balance safety with people’s independence, enabling them to continue doing the things that mattered to them.

Care plans included detailed and individualised risk assessments, covering both people’s health and support needs as well as risks within their home environments. This supported staff to provide consistent and safe care tailored to each person.

Where people had capacity to make decisions about their care, staff worked collaboratively with them to respect and fulfil their wishes safely. For example, one person chose to use continence products they had purchased themselves, and staff supported this choice while ensuring safe and appropriate use.

Staff were supported to deliver safe care through appropriate training and partnership working with external professionals. For example, staff received specialist training in the use of equipment such as ventilator masks, ensuring they had the skills and confidence to meet people’s complex needs. This enabled people to remain living safely in their own homes while maintaining their independence.

The provider ensured that people were supported in safe environments where potential risks were identified and effectively managed. Systems were in place to detect and control environmental risks, helping to promote people’s safety while receiving care in their own homes.

Care plans and risk assessments included clear guidance for staff on managing environmental risks specific to each person’s home. This included practical measures such as carrying out and recording weekly smoke detector checks, ensuring that safety equipment was functioning correctly and reducing the risk of harm in the event of a fire.

Important safety information was also clearly documented and accessible to staff. For example, the location of water and gas mains was recorded, enabling staff to respond promptly and appropriately in the event of an emergency. This supported staff to act quickly to minimise risks and keep people safe.

People told us they were support by a consistent team of staff who were suitably qualified, skilled, and experienced to meet their needs safely and effectively. Staffing levels were carefully planned to ensure continuity of care and to provide responsive, person-centred support. Staff worked collaboratively and communicated well, enabling them to deliver consistent care that reflected people’s individual preferences and requirements.

Robust recruitment processes were in place to ensure staff were suitable for their roles. New staff underwent appropriate pre-employment checks and were supported through a structured induction programme. This included a two-day induction covering key policies, procedures, and core competencies, alongside visits to people’s homes. Staff also completed a period of shadowing and mentoring with experienced colleagues before undertaking lone working, which helped to build confidence and competence in delivering care safely.

Staff spoke positively about the training and support they received. Training was comprehensive and equipped staff with the knowledge and skills required to carry out their roles effectively. One staff member told us, "I have the appropriate training for my role, and I always make sure I am working safely and following correct procedures. If there is ever anything I am unsure or confused about, especially if something has changed, I make sure to ask questions or contact members of staff for clarification and support." This demonstrated a strong culture of accountability and willingness to seek guidance when needed.

People who received care also expressed confidence in staff abilities. One person said, "Staff are knowledgeable about my condition and know how to help me with the equipment I use." This showed that staff had the necessary skills and understanding to meet people’s individual needs effectively. Ongoing supervision, support, and professional development opportunities were provided to staff, ensuring their practice remained safe and up to date.

People were protected from the risk of infection through effective systems and clear guidance for staff. The provider assessed and managed infection risks appropriately, ensuring safe care was delivered in people’s homes and that the spread of infection was minimised.

Care plans contained clear, individualised guidance for staff on infection prevention and control practices. This included detailed instructions on the correct use of personal protective equipment (PPE), specifying when items such as gloves and aprons should be used and what equipment was appropriate for each person’s needs. This supported staff to follow safe practices consistently.

Staff competence was regularly monitored to ensure infection control procedures were understood and followed in practice. Observations, spot checks and supervision were used to reinforce good practice and address any issues promptly, helping to maintain high standards of hygiene and safety.

People and their relatives spoke positively about staff practice. One person said, “Staff always wear gloves and things. They always throw them away properly too.” This demonstrated that infection control procedures were being followed consistently and gave people confidence in the safety of their care.

The provider ensured that medicines and treatments were managed safely and in a way that met people’s individual needs, capacities, and preferences. People were actively involved in decisions about their care, including when changes to their medicines or treatment regimes occurred, supporting a person-centred approach.

Clear systems were in place to ensure the safe administration of medicines. Medicine Administration Record (MAR) charts reviewed demonstrated that people consistently received their medicines as prescribed, including those that required administration at specific times. Care calls were carefully planned and scheduled to ensure medicines were given at the correct times throughout the day, reducing the risk of missed or delayed doses.

Staff responsible for administering medicines were appropriately trained and competent in their roles. Senior care staff received enhanced training to enable them to carry out effective audits and compliance checks. This oversight ensured that medicines practices remained safe, accurate, and in line with current guidance.

Where errors or areas for improvement were identified through audits or incident reporting, prompt action was taken. These were clearly communicated to staff and used as learning opportunities to improve practice. This proactive approach ensured that risks were minimised, lessons were embedded, and people continued to receive their medicines safely.