Background to this inspection
Updated
22 November 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 2 inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post. However, they had submitted an application to de-register and the service was being managed day to day by a new manager, not yet registered.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 19 October 2023 and ended on 23 October 2023. We visited the location’s office on 23 October 2023.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.
During the inspection
During the inspection we spoke with 9 members of staff including the managing director, the manager, 2 care co-ordinators, the training manager and 4 members of care staff. We looked at 8 care plans and 4 staff files. We looked at documents relating to accidents and incidents, medicines, auditing and quality assurance. We spoke with 4 people that used the service, 6 relatives and 2 professionals.
Updated
22 November 2023
About the service
Caremark Tunbridge Wells, Tonbridge and Malling is a domiciliary care agency providing care and support to people in their own homes. At the time of the inspection care was being provided to 53 people including 4 ‘live in’ clients. Some people lived with dementia and other health conditions which affected their health and wellbeing.
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.
People’s experience of using this service and what we found
There had been a lack of management oversight with follow up actions for accidents and incidents. Some risk assessments reviews were overdue and not all auditing processes had been completed. There was no formal way that people could provide feedback anonymously. The new manager had identified these issues and new systems and processes were in place however, these needed time to embed.
Staff were clear about their roles and responsibilities. Positive relationships had been made between staff and people which supported positive outcomes for people. People, relatives and staff all had opportunities to feedback about the service and were able to raise concerns and highlight aspects of the care and support provided they felt were working well. Although only in place for a short time, the manager had created a positive atmosphere and everyone spoke well of them, telling us they were approachable and provided a visible presence.
People were protected from harm and told us they felt safe. Risks had been assessed relevant to individuals and these were documented and made available to staff. Staff were able to tell us correctly, the steps they would take in the event of a safeguarding, an accident or other incident. They knew to make situations safe and to report to managers and other professionals if needed. Some people were supported with medicines and this was achieved safely by staff trained in medicine administration. People were protected from the risk of infection, staff had been appropriately trained and knew the correct procedures with personal protective equipment (PPE).
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 told us that staff were kind and treated them with respect and dignity. People’s privacy was respected and any cultural, faith or other specific needs were documented and supported. People were supported to be as independent as possible without compromising their safety.
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 this service was good (published 28 November 2017).
Why we inspected
This inspection was prompted by a review of information new held about the service.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained as good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caremark Tunbridge wells, Tonbridge and Malling on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.