Caremark Hinckley Bosworth & Blaby

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

People received safe care and support. Staff had detailed guidance of action required to meet people’s care needs and mitigate known risks. Staff had received training in safeguarding and knew how to protect people from abuse and avoidable harm.

People were positive about the competency of staff and felt confident they knew and understood their individual care and support needs. Staff were recruited safely.

Improvements had been made to care calls. There had been no missed calls and late calls were minimal. The management team monitored care calls and care records, to ensure people received care that reflected their assessed needs.

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.

Medicines were managed and administered safely where required. Staff had received medicines training and had their competency assessed. Care plans provided staff with guidance required to support the safe management of medicines.

Accidents and incidents were recorded, acted upon and analysed for opportunities of learning to reduce reoccurrence.

Infection prevention and control best practice guidance was followed. Staff wore personal protective equipment to reduce the risk of cross contamination and infection.

The provider’s systems and processes that assessed, monitored and reviewed quality and safety had been developed and improved upon. Further improvements were being implemented.

People were positive about the improvements made and spoke highly of the registered manager and management team. People received opportunities to share their experience about the service.

Overall, staff were positive about working for the service. Staff received ongoing training and their competency and performance reviewed. There were communication systems in place to share information with people and staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rated inspection for this service was requires improvement (published 29 July 2022). Breaches in regulations relating to safe care and treatment, fit and proper persons employed, and good governance were identified. The provider completed an action plan after the inspection to show what they would do and by when to improve and meet the breaches in regulation related to safe care and treatment and fit and proper persons employed. A Warning Notice was served for the breach relating to governance.

At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Caremark Hinckley, Bosworth & Blaby is a domiciliary care agency which provides care and support to people living in their own homes. At the time of our inspection the service was supporting 108 people, 88 of those people were in receipt of 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

Risks associated with people’s care were not always identified and recorded. Care plans did not always contain current and consistent information about people’s health needs.

Not all staff were recruited safely, and the deployment of staff was not always effective at meeting the needs of the people they supported.

The systems and processes to review care records and oversee the use of medicines was not effective.

We heard from people, their relatives and staff that calls were often delayed or cut short. Systems and processes in place to review call information, and to receive feedback from people, were not effective as they had not identified these concerns.

People, their relatives and staff gave mixed feedback about the leadership and the management of the office.

The registered manager had a good understanding of the duty of candour and they had a policy in place for this. The duty of candour is their legal responsibility to be open and honest with people when something goes wrong.

People and their relatives told us that they felt safe when receiving care.

Staff understood how to keep people safe and had received training in this.

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 26 June 2021).

Why we inspected

We received concerns in relation to staffing, missed calls, infection prevention and control measures and recruitment. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caremark Hinckley Bosworth & Blaby on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safe care and treatment of people, leadership and governance and recruitment of care staff at this inspection.

Please see the action we have told the provider to take at the end of this report.

We sent the provider a warning notice asking them to make changes. When we next return to inspect the service, we will consider what improvements have been made.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Caremark Hinckley, Bosworth and Blaby is a domiciliary care agency providing personal care to people living in their own homes or flats. Staff support a range of needs including younger and older adults, children and people living with dementia. At the time of the inspection the service was supporting 106 people, 81 of whom were being provided with the regulated activity of personal care.

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

People were supported to stay safe. Risks were identified and responded to. There was a system in place to report any incidents, including safeguarding concerns, which were analysed for any themes or trends. Peoples' staffing requirements were assessed individually and met. People received the support they needed to take their medicines safely and as prescribed. Staff followed current guidance and requirements to protect people from the risk of infections, including those associated with COVID-19.

People's needs were assessed before they started to use the service and these assessments formed the basis of care plans. Care plans were personalised and reflected people's wishes, preferences and specific needs. Staff received training to give them the knowledge and skills to meet people's needs. The provider was developing in-house training to expand face to face training for staff, particularly in specialist areas such as autism. People were supported to maintain their health and well-being.

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.

The provider had a range of systems and processes in place to monitor the quality of the care provided. People and relatives were encouraged to share their views and opinions about the service through a variety of consultative methods. Staff did not always feel they benefited from an inclusive culture. The provider was committed to developing consultation processes with staff to improve communications and working relationships.

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 19 June 2019).

Why we inspected

We received concerns in relation to staff deployment and training and the control and prevention of infection. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. We found no evidence during this inspection that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caremark Hinckley, Bosworth and Blaby 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.

People’s experience of using this service:

People were supported by staff who put them at the heart of what they do. Staff told us, ‘’The minute I walk in a client’s house, they come first,’’ and ‘’We are a good bunch of carers - we care.’’

People and relatives were happy with the service they received and spoke positively to us about staff with whom they had good relationships. We were told, ‘’When [carer] came, we laughed from beginning to end,’’ and, ‘I think they're very good.’’

We saw examples of staff going the extra mile for people, for instance, when one person’s house flooded, all Caremark carers in the local area attended and spent many hours clearing up and ensuring further support was in place from the local authority.

Appropriate recruitment checks took place before staff started work and there were enough staff available to meet people's care and support needs. We have made a recommendation about one aspect of recruitment processes.

Staff received comprehensive training to enable them to carry out their roles effectively, although new carers would benefit from additional opportunities to learn from more experienced staff.

Staff enjoyed working at the service and felt supported by each other and their supervisors. We were told,‘’It’s a really good team.’’ And,‘’This is a good company. They do care about the clients - and the staff.’’

Care records contained clear information covering all aspects of people's individualised care and support. Information about people was written in a respectful and personalised way

People and their relatives were involved in the planning and delivery of their care.

When there were problems, the provider dealt with them appropriately and put measures in place to reduce the likelihood of recurrence.

The director and registered manager recognise the importance of retaining staff and are keen to improve and extend the service by using new technology and promoting good practice.

Rating at last inspection: Rated good, report published 17 August 2016.

Why we inspected: This was a scheduled inspection based on the rating at the last inspection.

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Caremark –Hinckley, Bosworth and Blaby is a domiciliary care agency that provides personal care to people in their own homes. On the day of our inspection the service was supporting 60 people.

The service had a registered manager. 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 and associated Regulations about how the service is run.

People felt safe in their own homes. Call times were monitored to ensure that people received their care at agreed times.

The registered manager had assessed the risks associated with providing care in the home environment. Risk assessments were reviewed periodically in line with the provider’s guidelines. Risk assessments were under review at the time of our inspection.

Staff understood how to keep people safe and report concerns if needed. Where concerns had not been raised at the time with relevant outside agencies the registered manager had identified this and notified them retrospectively. Staff had undergone relevant employment checks.

Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported. Their competence to do their role was regularly assessed.

Some people had the capacity to make decisions about their care and the support they received. These people were involved in the planning of their care and their opinions sought and respected. The service did not follow the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards DoLS), best interest decisions had not been made in line with the Act.

People were supported to maintain their health and wellbeing. They were promoted to take their medicines by staff. People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have sufficient to eat and drink.

People were treated with kindness and respect. People’s independence was promoted and choice making encouraged. Staff knew people well and treated them with kindness and compassion. People received a consistent level of support.

The registered manager had assessed the care needs of people using the service. Staff had a clear understanding of their role and how to support people who used the service as individuals. People were involved in the planning of their care and their feedback was sought.

Staff felt supported by the manager. They were clear on their role and the expectation on them. Most people who used the service and staff felt that they could talk to the manager and had confidence that they would address issues if required. People told us that they knew how to make a complaint if they needed to. Relatives found the registered manager to be approachable.

The registered manager had implemented systems to monitor the provision of service. There were effective systems for gathering information about the service, identifying areas of concern and to drive improvement. The registered manager had taken action to address concerns.

People had been involved in making arrangements about the way their care and support was to be delivered. Their needs and preferences had been taken into account and they had signed documents to confirm they agreed with the arrangements that were in place.

Care was planned and delivered in a reliable way. We looked at the records of three people who used the service and found that these were up to date and reflected people's current needs. People told us that staff arrived on time and carried out all the tasks that were needed.

Staff had been supported to enable them to deliver safe and effective care. They had received appropriate induction training at the beginning of their employment. The manager of the service completed regular checks to make sure that staff carried out their roles effectively.

The provider had systems in place to monitor the overall quality of the service. This included speaking to people who used the service to ask them for their views and checking written records to ensure they were properly completed.

At the time of our inspection the registered manager was temporarily absent. The provider had taken appropriate action and informed the Care Quality Commission about this absence. An acting manager was in place with responsibility for the day to day management of the service.