Caremark (Barnsley)

Updated 27 November 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 one inspector and an Expert by Experience, who made phone calls to people using the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

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

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was to be sure that the provider or registered manager would be in the office to support the inspection, as well as letting the service know we would be making phone calls to people. We visited the service’s office on 12 and 13 November 2019.

What we did before the 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.

During the inspection

We spoke with nine people who used the service about their experience of the care provided and also viewed multiple satisfaction surveys, which people had completed recently. We spoke with twelve members of staff including the provider, registered manager, care and support workers, as well as senior and office staff.

We reviewed a range of records. This included eleven people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including surveys, quality checks, reports and procedures were reviewed.

Following the inspection

We received additional feedback from the local authority. This informed us the service was not to receive further referrals until a safe, reliable quality service had been re-established for people. We understood care packages had been reallocated by the local authority and they were closely monitoring the service for improvements on a weekly basis. The registered manager sent additional information which we reviewed.

Updated 27 November 2019

About the service

Caremark (Barnsley) is a domiciliary care service providing personal care to 170 people in their own houses and flats in Barnsley and surrounding areas at the time of the inspection. The service supported people of all ages, with different health and care needs.

Not everyone who used the service received personal care. The Care Quality Commission (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 told us they were overall satisfied with their care when they received it, that staff were appreciated, well-liked and able to adapt to their changing needs. A main and significant issue which impacted on people however was the lack of reliability in call times and staffing. The provider and registered manager were honest about their current staffing issues. These had led to the service having to hand care packages back to the local authority, as well as a stop in receiving referrals until a more reliable, safe service had been established for people.

The Care Quality Commission (CQC) had not always been notified of certain events in line with the provider’s legal obligations. We saw however examples of such events having been investigated appropriately by the service. At the previous inspection we found governance systems had not always ensured a good quality service. We found some improvements at this inspection. The wider service staffing issues meant progress was slower than hoped for and more time and support was needed. The consistency of good governance still needed to be improved, including aspects of quality assurance. We made a recommendation regarding this, as well as the consistent completion of staff supervisions.

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 generally supported this practice. This had been addressed since the last inspection, however we made a recommendation for further, continued improvements.

The provider was implementing a new electronic governance system, to help monitor and progress the service. A positive example of service progress made was the appointment of medication champions, which had led to improvements. We highlighted a few areas for development, to ensure clear directions were given to staff when helping people with their medicines.

However, people and staff we spoke with were consistent in their praise for the caring culture of the service, which was led by a well-respected registered manager and their office team. The registered manager was honest that taking time to find the right, quality candidates meant slower progress in recruitment, but they did not wish to compromise on this. People praised care staff who supported their independent living and daily well-being. Care staff were knowledgeable of people, their needs, as well as backgrounds, and people praised this. Care plan development was ongoing; however we saw some good examples of progress already made and people felt involved in the planning of their care.

People described care staff generally as hard-working and carrying out a good standard of care with a supportive management system in place. People’s comments included, “They are kind and a great help with everything I need for my care plan. The carers know my personal requirements which is reassuring for me and my family” and “They are the source to my limited independent life. I am very happy to recommend these so helpful and kind people.”

The service worked with a variety of professionals to promote or maintain people’s health and wellbeing, as well as to achieve positive outcomes. Further opportunities to involve people using the service and staff had been introduced with regular coffee mornings. These also showed the service’s understanding of their role in trying to reduce people’s social isolation. Managers were continuously exploring additional learning opportunities to develop their own best practice as well as the staff team’s.

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 rating for this service was requires improvement (published 16 November 2018). At the last inspection we found the provider was in breach of regulations regarding good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches at this inspection in relation to staffing and notifying the Care Quality Commission (CQC) of certain events. Please see the action we have told the provider to take at the end of this report.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.