Caremark (Kingston)

Caremark (Kingston) is a domiciliary care agency providing care and support to people in their own homes and flats.

The Care Quality Commission (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 the inspection 65 people were receiving a personal care.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were provided with a safe service and staff had a safe environment to work in. There were suitable numbers of appropriately recruited staff employed to meet people’s needs. This meant people were supported to enjoy their lives and live safely. Risks to people were assessed, monitored, and recorded by the registered manager and staff who updated records when required. Accidents, incidents, and safeguarding concerns were reported, investigated, and recorded appropriately. People were supported and prompted to take their medicines, by staff as needed. Infection control procedures were followed.

People and their relatives told us that effective care was provided, they had not experienced discrimination and their equality and diversity needs were met. Staff were well-trained and supervised. People said staff provided good, focused care that met their needs, and they were encouraged to discuss their health needs. Any changes to them or concerns were passed on to appropriate community-based health care professionals. This included any required transitioning of services if the people’s needs changed. People were protected by staff, from nutrition and hydration risks, and they were encouraged to choose healthy and balanced diets that also met their likes, dislikes, and preferences.

People said staff provided care and support in a friendly manner, paying attention to small details which made all the difference. Staff acknowledged people’s rights to privacy, dignity, confidentiality, and people felt respected. They were encouraged and supported to be independent and do things for themselves, wherever possible. This improved their quality of life and promoted their self-worth. Staff were compassionate, cared about people, and passionate about the person to whom they provided a service.

The provider responded to the people’s needs and assessed, reviewed, and appropriately adjusted their care plans as required. This included any communication needs. People were provided with person-centred care, given choices, and encouraged to follow their routines, interests and maintain contact with friends and relatives so that social isolation was minimised. They received enough information about the service to make their own decisions regarding whether they wished to use it. Complaints were recorded and investigated.

The service was well-led. The provider’s culture was positive, open, and there was a clearly identified leadership and management structure. The provider had a vision and values that staff understood, followed and they were aware of their responsibilities and accountability. Staff said they were happy to raise any concerns they may have with the provider and take responsibility. The quality of the service was regularly reviewed, and any required changes made to improve the care and support people received. This was in a way that suited people best. There were well established effective working partnerships that promoted the needs of people being met outside the provider’s remit. Registration requirements were met.

Why we inspected

The last rating for this service was Good (published 24 August 2018).

We undertook this inspection to check whether the service was continuing to provide a good, rated service to people.

The overall rating for the service has remained Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Caremark (Kingston) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection was carried out on 17 and 18 July 2018 and was announced. 48 hours before the inspection we contacted the service to let them know that we will be coming to inspect them. We wanted to make sure that the registered manager will be available on the day of inspection.

At the last inspection carried out on 29 February 2016, the service was rated Good. At this inspection we rated the service overall Good, with Requires Improvement in effective.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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.

Although new staff underwent a comprehensive induction training programme, the registered manager had not supported staff to ensure their knowledge and skills were regularly updated through ongoing training. We have made a recommendation about this.

Processes and procedures were followed as necessary to support people to stay safe from abuse and any incidents and accidents occurring. There were comprehensive risk assessments in place to protect people from a risk of fire. Staff had to undertake all the required pre-employment checks before they started working with people which ensured their suitability for the role. Staff were aware of people’s care needs and the support they required to take their medicines safely.

People had the necessary assistance to move around their homes which helped them to maintain their independence. Staff said the management team provided effective support to them which meant that staff were able to carry out their responsibilities as required. People’s health needs were adhered to when they required medical attention. The service monitored people’s ability to make decisions for themselves and provided support to people if they were unable to do that themselves as required by the Mental Capacity Act 2005 (MCA).

People spoke positively about the staff team and how well the individual staff members cared for them. Staff were kind, friendly and attended to people’s needs and preferences as required. People felt their dignity was enhanced which helped them to maintain their self-esteem. Staff were aware of people’s cultural needs and communicated to people in ways they could understand.

People’s care needs were assessed and monitored as necessary which provided staff with guidance on the support people required. People and their relatives were supported to raise concerns and complaints and felt confident to approach the management team for making changes to their care if necessary.

People, their relatives and the health professionals we spoke to felt that the service was well led which ensured safe care for people. Systems were in place to support and motivate staff in delivering good care for people. We saw audits being regularly carried out to check if people’s care records reflected their needs as necessary.

Caremark (Kingston) provides domiciliary care and support to 170 people of all ages, some of whom may have dementia or a physical or mental health need. Caremark (Kingston) is part of a franchise that delivers care to people in many areas of the United Kingdom. This includes personal care such as assistance with bathing, dressing, eating and medicines; home help covering all aspects of day-to-day housework, shopping, meal preparation and household duties. Of those 170 people 95% received personal care and the remainder receive only help in their home. We only looked at the service for people receiving personal care during this inspection as this is the part of the service that is regulated by the Care Quality Commission.

The service had a registered manager in post. 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 told us they felt safe with the support they received from staff. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service and staff how to report potential or suspected abuse. Staff we spoke with understood what constituted abuse and were aware of the steps to take to protect people.

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe. The provider ensured there were safe recruitment procedures in place to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

Staff received training in areas of their work identified as essential by the provider. We saw documented evidence of this. This training enabled staff to support people effectively.

Appropriate arrangements were in place in relation to administering and the recording of medicines which helped to ensure they were given to people safely.

The manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. Records showed people were involved in making decisions about their care and support and their consent was sought and documented.

People were involved in planning the support they received and their views were sought when decisions needed to be made about how they were supported. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

Staff respected people’s privacy and treated them with respect and dignity. Staff supported people according to their personalised care plans.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner.

Staff gave positive feedback about the management of the service. The manager and provider were approachable and fully engaged with providing good quality care for people who used the service. They encouraged a positive and open culture by being supportive to staff and by making themselves approachable with a clear sense of direction for the service.

The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions and action plans were developed where required to address areas for improvements.