7 September 2022
During an inspection looking at part of the service
Caremark Colchester is a domiciliary care service providing the regulated activity of personal care. The service provides support to people in their own houses, flats or specialist housing accommodation. At the time of our inspection there were 22 people using the service.
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
The absence of effective quality assurance and governance arrangements at Caremark Colchester provided no assurance the service was well led and regulatory requirements were being met. Quality assurance systems had not identified the shortfalls found during this inspection. No information was available or recorded to demonstrate the provider had effective arrangements in place to recognise where improvements were needed and lessons learned. The absence of the provider and a registered manager since September 2021, had a detrimental effect on the overall running of the service.
Where safeguarding concerns were raised, internal investigations were not commenced or completed in response to the allegation of harm. The incidence of safeguarding concerns was not recorded and the Care Quality Commission had not been notified of all safeguarding concerns. Not all risks for people were identified and recorded in relation to their care and support needs to ensure their safety and wellbeing. Improvements were required to medicines management. The provider did not ensure staff were suitable to work with people using the service. Variable comments were raised with the Local Authority relating to the timing of calls by staff. The provider did not ensure all staff employed at the domiciliary care service had received appropriate training or an induction.
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. However, most staff had not received training on the principles of the MCA. Not all staff spoken with had a good understanding of the MCA and its impact on people using the service.
Staff confirmed they had enough supplies of Personal Protective Equipment [PPE] available to ensure safe infection, prevention and control practices. Staff supported people as needed with the provision of meals, snacks and drinks. People had access to health professionals as required.
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 April 2020]
Why we inspected
The inspection was prompted in part due to concerns about a lack of engagement by the provider with the Local Authority and Care Quality Commission. The most recent audit conducted by the Local Authority in June 2022, recorded an overall score of ‘Poor’. A decision was made for us to inspect and examine those risks.
Enforcement and Recommendations
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 provider’s governance arrangements, staff training and induction at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.