Caremark (Slough and South Bucks)

Updated 14 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by an inspector and an expert by experience. An Expert by Experience (EXE) is a person who has personal experience of using or caring for someone who uses this type of care service. They made telephone calls to discuss people’s experiences of the care and support received.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection site visit activity started on 18 June 2019 and ended on 20 June 2019. We visited the office location on all three days to see the registered manager and office staff; to review care records; policies and procedures and records relating to the management of the service. The EXE made telephone calls to people on the 18 June 2019.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

We received feedback from an adult social care professional and viewed recent feedback given by people and relatives on a social media website. These were included in this report.

During the inspection-

Throughout the inspection we gave the provider and registered manager opportunities to tell us what improvements they had made since our last visit.

During our visit we spoke with eight people, four care workers, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We viewed four care records; five staff files and their training records, five staff supervision records; training data and a variety of records relating to the management of the service, including policies and procedures. After our visit we received feedback from an adult social care professional and included this in the report.

Updated 14 August 2019

About the service:

Caremark (Slough and South Bucks) is registered to provide personal care to people living in their own homes. At the time of the inspection 39 people were being supported with personal care. The main office is based in Windsor.

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:

People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible and in their best interests. However, management did not always complete mental capacity assessments and document all best interest decisions. We have made a recommendation about this in the report.

People were overwhelmingly positive about the care and support received. Comments received included, “I like Caremark's service. Very good and the carers are very helpful", The care has been outstanding, appreciate the flexibility when needed", "Caremark are very helpful, good and caring" and "All the carers are lovely and treat me well. Thank you for all they are doing for me." Staff demonstrated a good understanding of how to deliver personalised care.

People and those who represented them said they felt safe from harm and were given information about what to do if they felt unsafe. Staff had a good understanding and awareness of abuse and had attended the relevant training. Staff were aware of risks to people’s well-being and how to manage them. There were enough staff to support people to stay safe and meet their needs. Safe recruitment practices were in place to ensure people were cared for by staff with good character. There was safe administration of medicines as the service followed relevant national guidance. People said staff followed good hygiene practices and training records confirmed staff had attended the relevant training.

People and those who represented them felt staff were skilled and experienced to look after them. Staff were appropriately inducted and spoke positively about their training and supervision. People received appropriate support to maintain their nutrition and hydration needs. The service worked in partnership with other health and social care agencies to achieve good health outcomes for people.

People and those who represented them said the care received met their specific needs. Assessments showed planning of care was focussed on people’s whole life, their wishes and needs on the grounds of protected equality characteristics. People said they were involved in decisions about their care. The service helped to protect people from the risk of social isolation.

The service was compliant with Accessible Information Standard by making sure the communication needs of people with a disability or sensory loss was flagged; shared and communicated. Regular reviews of care ensured staff were aware of any changes in people's circumstances and systems were in place to deal with any complaints. Discussions in relation to people’s preferences for end of life care were not always documented in people’s care records. We have made a recommendation about this in the report.

People, those who represented them, and staff felt the service was consistently well-managed. The service had a positive culture that was person-centred, open and inclusive. Staff said they felt respected, valued and supported. There were effective quality assurance systems in place to evaluate accurate information about the quality and safety of the care and support that was provided. The service sought the views of people, those who represented them and staff, to understand where improvements were needed. The service developed good working partnerships to support care provision and joined up care. There was an open culture of learning from mistakes and changes were made to service delivery due to lessons learnt.

Rating at last inspection: The last rating for this service was good (published 20 December 2016).

The overall rating for the service remains unchanged and the service is rated good. This is based on the findings at this inspection.

Why we inspected

This was a planned inspection based on the previous rating.

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.

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