Caremaid Services Limited

Updated 16 January 2019

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 16 October 2018. The inspection was completed by one inspector and an expert-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.

We gave the service 48 hours’ notice of the inspection visit to ensure the registered manager would be in. Before the inspection we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.

The provider had 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. This information was reviewed to see if we would need to focus on any particular areas at the service.

Before the inspection we contacted 31 people who used the service and 14 people, or their relatives agreed to talk with us . We spoke with five staff, which included the registered manager and the provider of the service). We also reviewed care and other records within the service. These included six care plans and associated records, six medicine administration records, three staff recruitment files, and the records of quality assurance checks carried out by the provider.

We also contacted three social care professionals to see if they had any information to share about the service.

Updated 16 January 2019

Abbey House (Caremaid Services Ltd) provides a range of services to people in their own home including personal care. Most people using the service were older people, some of whom were living with dementia. At the time of our inspection 103 people were receiving personal care in their home. Most people were funded by their local authority. We gave the service 48 hours’ notice of the inspection visit to ensure the registered manager would be in.

Not everyone using Abbey House (Caremaid Services Ltd) receives a regulated activity; 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.

The registered manager was present during the inspection. 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 did not always receive a safe service from Abbey House (Caremaid Services Ltd). We had feedback from people that use the service and service commissioners about concerns with the timeliness and consistency of staff. The provider sent us information after the inspection about how they had addressed these concerns. Time was now needed for the provider to evidence the changes made had been so that people had their support at the agreed times, and with consistent staff wherever possible.

Hazards to people’s and staff’s health and safety had been assessed. Information on how to manage and minimise the risk of harm were in place and understood by staff. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

Staff recruitment procedures were safe. The provider had undertaken appropriate safety checks to ensure that only suitable staff were employed to support people in their own home. There were sufficient numbers of staff who were appropriately trained to meet the needs of the people who used the service. The provider was looking at ways to improve staff’s punctuality, as this was the main complaint people had about the service.

Staff managed the medicines in a safe way and were trained in the safe administration of medicines. Staff understood the need to protect people fomr the spread of infections.

Prior to people joining the service a detailed assessment of their needs was completed. Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). Staff understood that they had to gain people’s consent before they provided care, and that they could not make decisions for people.

Where required staff supported people to have enough to eat and drink. This varied from buying and preparing meals for people who needed help eating to checking that people had eaten something for those who were more independent.

People were supported to maintain good health. Staff responded quickly if people’s health deteriorated. They made sure they contacted the appropriate professionals to ensure people received effective treatment. Emergency plans were in place to deal with situations that may stop the service running, such as adverse weather. These had proved effective earlier in the year during a period of bad weather.

People told us that the staff were kind and caring and treated them with dignity and respect. The staff knew the people they cared for as individuals, and had a good rapport with relatives.

People received the care and support as detailed in their care plans. Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference so they knew what support was required. People were supported by staff to maintain as much independence as possible.

People knew how to make a complaint, and told us they would feel comfortable doing this. Staff knew how to respond to a complaint and welcomed them as an opportunity to improve the service.

The provider had effective systems in place to monitor the quality of care and support that people received. The provider had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained. The registered manager regularly visited people in their homes, or the office telephoned them to give people an opportunity to talk, and to ensure a good standard of care was being provided.

Records for checks on health and safety, and medicines audits were all up to date. Accident and incident records were kept, and were analysed and used to improve the care provided to people.

We have made one recommendation in the report for the provider to continue to monitor and address feedback about late calls.