Archived: Caremark (Wakefield)

The inspection took place on 12 and 14 October 2016 and was announced. The service was previously inspected on 3 June 2013 and met all the requirements in place at that time.

Caremark (Wakefield) provides a domiciliary care service for approximately 70 people in the Wakefield area of West Yorkshire. They are registered to provide the regulated activity of personal care to people from birth upwards with a physical and sensory impairment. It is a condition of registration with the Care Quality Commission that the service has a registered manager in place and there was 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.

Staff had received training in safeguarding adults and children. They demonstrated a good understanding of how to recognise abuse and ensure people were safeguarded. They knew the procedure to follow to report any concerns.

Environmental risks had been assessed to ensure a safe working environment for staff. The service had assessed the risks to people supported, but we found the measures put in place to mitigate risk were not always recorded.

We found people had assistive equipment in place which was not referenced in their moving and handling care plans and the method staff were to follow when moving and positioning people did not contain sufficient detail for staff to follow.

We found some issues with the management of medicines including medicines not individually listed on the medicine administration record when provided in a monitored dosage system and some gaps in the records which had no reason recorded against this.

All staff had been checked against the Disclosure and Barring Services (DBS) to ensure they were safe to work with vulnerable people. However, gaps in employment history had not been recorded and one candidate’s reference contained incorrect dates which had not been picked up.

Staff received regular training to ensure they developed skills and knowledge to perform in their role and received regular ongoing supervision and an appraisal to support their development. Staff competency was checked through frequent spot checks by the field care supervisor.

The registered provider was not meeting its responsibilities under the Mental Capacity Act 2005. No capacity assessments or best interest decisions had been recorded and staff did not have a good understanding of the principles of the Act.

People were cared for by staff who were caring and compassionate and who respected their dignity and privacy.

People told us staff were responsive to their needs and provided care to their preference and choice. They told us they were frequently asked for their views about the care provided and felt they could influence how care was provided.

The service had a complaints policy in place and complaints were handled appropriately to ensure a satisfactory outcome for people using the service. A record was kept of all compliments received and when these related to staff, these achievements were publicly recognised.

Staff told us they enjoyed working at the service and wanted to provide a good standard of care to the people they supported. They told us the registered manager was supportive.

We found shortfalls in audits to monitor the quality of service provision around for example, the safe administration of medicines, and care plans.

We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in Regulation 12; Safe Care and Treatment and Regulation 17; Good governance. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with seven people who used the service or their representative by phone to gain their views. All of the people spoken with were very complimentary about the service they received. They all said the service was reliable and confirmed the carers always visited when they were expected. One person commented: 'Punctuality is a rare thing these days but these carers are very good. You can set your clock by them.' Another person commented: 'The care is absolutely great.'

We spoke with four members of staff who were all knowledgeable about the care and support needs of the people they visited. They confirmed they had attended regular training in relation to their work and said they felt suitably skilled and qualified to do their job.

We reviewed eight people's care records. We found some of the care plans did not clarify important relevant information. For example, care plans relating to medication did not clearly indicate the level of support the person needed from the carer in sufficient detail. We discussed this with the manager who took immediate action to correct this.