Archived: Caremark Norwich

The inspection took place on 22 and 23 March and we contacted the service before we visited to announce the inspection.

Caremark Norwich provides domiciliary care to around 128 people living in their own homes, some of whom may be living with dementia or long term conditions.

There was a registered manager in place. A registered manager is a person who has registered with the CQC 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 were supported by staff who were knowledgeable in their roles and demonstrated the skills required. They had been safely recruited and were well-trained. Staff had been selected for their person centred approach and their willingness to care for people. Staff told us they felt supported in their roles. Staff were motivated and passionate about the people they cared for and the service they provided.

Staff demonstrated they understood how to prevent and protect people from the risk of abuse. The service had procedures in place to report any safeguarding concerns to the local authority. People and staff were protected from harm as the service had identified and assessed any risks to them and reviewed these on a regular basis. Risk assessments were individual to the person and their environment.

Medicines were administered in a consistently safe manner. Medicines administration records were clear and accurate. They contained the relevant information. Staff understood safe procedures for administering medicines.

Staff received training and opportunities to further improve their skills and knowledge. Staff were undertaking qualifications and were given regular opportunities to discuss their performance with the management team. The competencies of staff were regularly assessed and recorded to ensure an appropriate standard of care was delivered.

People benefited from staff who felt valued by the service and were happy in their work. They had confidence in the management team and the service they were providing.

People were treated in a respectful, compassionate and caring manner. They told us they felt in control of their lives. Staff demonstrated that they understood the importance of promoting people’s dignity, privacy and independence. They gave examples of a caring and empathetic approach to the people they supported.

Staff had received training in the MCA and demonstrated they understood the importance of gaining people’s consent before assisting them.

Care and support was delivered in a person-centred way. The service had completed detailed assessments of people’s needs. People received individualised care as their care plans had been developed in collaboration with them. The service regularly reviewed people’s needs and made changes as required.

Staff assisted people, where necessary, to access healthcare services. Staff had a good understanding of people’s healthcare needs and demonstrated they had the knowledge to manage emergency situations should they arise.

Staff supported people to maintain their interests and avoid social isolation. The service worked jointly with other professionals to maintain people’s wellbeing.

The management team demonstrated an inclusive approach to the management of the service and people had confidence in them. They were supportive, accessible and actively encouraged people to comment on the service they provided.

People felt comfortable making a complaint. There were effective systems in place to monitor the quality of the service.

The manager had begun joint working with partnership organisations to develop the service.

Following this inspection the provider sent us a report about the changes they had made to comply with the regulation they were not meeting. This showed us that, where staff had been employed by the organisation for a year, they had now received an appraisal. We also found that significant efforts had been made to reduce the number of staff supervisions that were outstanding.

This review established that improvements had been made. This meant that the service was effective in ensuring that people were supported by staff that were suitably appraised and supervised.

We reviewed the evidence we had obtained during our inspection and used this to answer five key questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

This is a summary of our findings. If you would like to see the evidence supporting this summary please read the full report.

Is the service safe?

People we spoke with told us they felt safe with the service's staff and that they were never let down with missed calls. One person told us, 'I know I can rely on them, they've never let me down yet.'

Staff had received training in infection control and food hygiene. This meant that they were aware of the risks associated with cross contamination and took appropriate steps to minimise the risks to themselves and the people they supported.

We found that people using the service were not being deprived of their liberty. The manager was aware of their responsibilities in this area should such concerns arise.

Is the service effective?

People told us that they were happy with the care that had been delivered and their needs were being met by the service. Their health and care needs were assessed with them present and we saw from the service's records that people participated in their care plan and risk assessment reviews.

Records showed us that staff training was up to date. We were told by staff we spoke with that they were encouraged and offered opportunities to expand their knowledge and skills on a regular basis.

Staff supervisions were being carried out, but at a reduced level due to the absence of a key post being filled. However, recruitment to this post was underway. Although the provider had a staff appraisal system in place, no appraisals had been carried out in the last few years. This meant that staff were not always sufficiently supported to carry out their duties effectively.

Is the service caring?

People we spoke with told us that the service they received was caring. We were told that staff who supported them made every effort to ensure that all their care needs had been met during their calls.

We saw that plans were in place to inform staff what aspects of personal care some people felt sensitive about and noted guidance for staff on how to make sure they upheld people's dignity.

Is the service responsive?

People told us that if they needed adjustments to the service they received, this was organised efficiently. For example, some people occasionally required extra hours support for specific additional tasks. We were told that the service accommodated their requests.

We found that people had access to the provider's complaint policy and procedures. People knew how to make a complaint if they were unhappy. No-one we spoke with had felt the need to make a complaint. Occasionally people had asked for a change in care staff and this had been readily accepted and altered upon request.

Is the service well-led?

The service had various systems in place to monitor the quality of the service provided to ensure that it met people's needs. A survey was underway to obtain the views of people using the service and those of staff members.

Staff we spoke with were clear about their roles and responsibilities. They told us the manager and their support team were always available to answer queries and provide support. They told us that the service was well organised and well managed.