We carried out a review of the data available to us about Caremark (Rotherham) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Caremark (Rotherham), you can give feedback on this service.
Caremark (Rotherham) is a domiciliary care agency providing support for people in their own homes. The service was supporting 21 people at the time of the inspection. The majority of the people being supported were under 18
People’s experience of using this service and what we found
Everyone we spoke with was very positive about the care and support they received. They said they felt safe with the care staff and felt staff were appropriately trained to provide support. One relative described how staff had recently received training to meet their relative’s specific needs.
One person’s relative told us how the provider had ensured their provision changed to meet the person’s changing support needs, and one person using the service described their experience as “great.”
The registered manager and care staff were approachable, and people felt able to raise any concerns directly with them. Staff said they felt well supported and received the training they needed for their role. Staff were safely recruited. One staff member described the provider as “on the ball, any problems or changes and they sort it out.” Another described how the provider had supported them around difficult personal circumstances. All the staff we asked said they would recommend Caremark (Rotherham) as an employer.
Care plans and risk assessments were in place to identify the support people wanted. People and their relatives were involved in agreeing and reviewing their care plans.
Staff received an in depth induction and regular, ongoing training to enable them to undertake their roles. Staff told us they found the training to be useful and informative. One staff member said: “You get all the training you want, anything you ask they provide it.”
The registered manager and wider management team had oversight of the service through regular contact with people, their families and staff to gain feedback on the service. Care plans were reviewed regularly to ensure they met people’s needs, and spot checks were formally recorded with staff. Daily records were reviewed by the management team.
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 Requires Improvement (published July 2019.)
Why we inspected
This was a planned focussed inspection based on the rating at the last inspection. As this was a focussed inspection, we reviewed the key questions of safe, responsive and well led only.
Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
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.
Caremark Rotherham is a domiciliary care agency proving care and support to people in their own homes in the community. The service provides support to predominantly children and adults with physical disabilities.
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.
On the day of our inspection 35 people were using the service.
People’s experience of using this service:
At the time of our inspection the provider was actively recruiting staff to ensure adequate staff were employed to meet people’s needs. Many staff told us they were covering numerous shifts due to shortages and at times felt pressured to cover and this caused them concern. Recruitment process was followed however, we found there was not always a full employment history.
Medication systems were in place however, these were not always followed, and it was not possible to evidence from documentation that medicines were given as prescribed. The provider and registered manager commenced actions to address this at the time of our inspection.
Risk assessments were in place and an overview assessment. Some detailed people’s risk management however, some lacked detail to be able to manage the risk safely. These were being reviewed at the time of the visit.
Most staff were knowledgeable about people’s needs and training was mostly up to date or booked to ensure staff were updated. However, due to the complex care needs of people who used the service the training of staff took time to ensure they were competent.
Most staff we spoke with felt unsupported by the field care supervisors and did not feel they received effective supervision. Although staff did say they felt the registered manager was supportive when they contacted them. Staff told us on many occasions they could not get hold of managers or other office staff so felt isolated.
Staff, people who used the service and health care professionals we spoke with told us the communication could be improved as the communication with the office at times was poor. We were told that when issues were raised they were not passed to the correct person to deal with. Therefore, we had mixed feedback from people and relatives we spoke with, some felt listened to and said complaints were appropriately dealt with and resolved. However, others said they were not listened to and were very frustrated. Although one person said, “When I got to speak with the manager things did get sorted.”
People told us staff made them feel safe. No one we spoke with raised any concerns regarding safety. One person said, “The staff make me feel safe.”
Staff we spoke with understood safeguarding procedures and how to whistle blow if required to ensure any safeguarding concerns were reported. The registered manager monitored accidents and incidents to try to ensure lessons learnt. People were protected by the prevention and control of infection. People who required support with their diet had their needs met by staff that understood their dietary requirements. We saw people had access to health care professionals.
Staff supported people to make their own decisions and choices. Staff we spoke with were knowledgeable and understood the principles of The Mental Capacity Act. The Registered manager was currently working with health care professionals updating capacity assessments at the time of our inspection.
The registered manager tried to ensure all people they provided a service to have the same group of staff supporting them to ensure consistency. However, due to staff shortages this was not always possible. People told us their care staff were kind and caring, respected them and maintained their dignity. People received personalised care. Care plans were being improved at the time of our inspection to ensure management of needs was fully detailed.
The home had a registered manager who conducted a range of audits in areas such as, medicine management, health and safety, care plans and daily records documentation. However, we found the monitoring was not always effective. For example, it had not identified the issues we found in medicines management. We discussed this with the provider who agreed the audits could be improved and told us this would be addressed.
More information in Detailed Findings below.
Rating at last inspection:
At the last inspection the service was rated Good (report published March 2018).
Why we inspected:
The inspection was prompted in part due to concerns received about care and support provided, lack of experienced staff, staff not supervised, poor office management, a Lack of detailed care plans for staff to follow and a number of safeguarding concerns raised by the local authority. A decision was made for us to inspect and examine those risks.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to younger adults and children.
This was Care Mark Rotherham's first inspection since they registered with the Care Quality Commission (CQC) in December 2016.
The service did not have a registered manager in post at the time of our inspection. However, the registered provider has informed us since our inspection that a new manager has been appointed. 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. Staff understood their roles and responsibilities to safeguard people from the risk of harm.
Risks had been assessed for each person and were safely managed. Risk assessments had been carried out in relation to nutrition, skin care, and mobility. Risk assessments relating to each person's home environment had been completed. Where concerns were identified, action had been taken to reduce the risks to people.
People were supported safely with their medicines and told us they were happy with the support they received. Staff completed medication administration record (MAR) sheets after giving people their medicines.
Staffing levels ensured that people's care and support needs were met safely and safe recruitment processes were in place.
People received good healthcare support and were supported to receive a nutritious and balanced diet.
Infection control was adhered to by staff. Staff were provided with personal protective equipment to ensure the risk of cross infection was reduced.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
Risks were assessed and recorded by staff to protect people. There were systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.
People had good relationships with the staff, and told us the staff were kind and caring. Staff respected people’s privacy and dignity and promoted their independence.
The service had an open culture which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive improvement.
There were policies in place that ensured people would be listened to and treated fairly if they complained about the service.
We saw that the registered provider had systems that were effective to monitor and audit the quality and safety of the service and that people who used the service and their relatives were involved in the development of the agency and were able to contribute ideas.
Further information is in the detailed findings below