11 July 2013
During an inspection looking at part of the service
We did not speak with people who used the service regarding this outcome as on the day of our inspection the agency was not administrating medication for anyone who used the service.
We did not speak with people who used the service regarding this outcome as on the day of our inspection the agency was not administrating medication for anyone who used the service.
Risk assessments had not been reviewed, updated and in some cases were not completed.
The agency had sufficient staff with the right knowledge, experience, qualification and skills to support people. However, regular staff supervision had not been undertaken by the agency.
Records were kept securely and could be located promptly.
We found that the service had made significant improvements to ensure compliance with requirements relating to workers. We found that there were appropriate recruitment and selection processes in place which ensured that people were cared for by suitably qualified, skilled and experienced staff.
People we spoke with were generally happy with the service they received. However, people felt that the agency had not kept them informed about changes in connection with care staff being late or being unable to attend a home visit.
Staff had undertaken training in safeguarding vulnerable adults. The home held a copy of the Hertfordshire County Council's policy and procedure on safeguarding adults from abuse. All staff we spoke with were able to explain how and where they would report any suspicion of abuse they may have.
People confirmed that staff wore a uniform and had their identification badges with them when making visits.
Staff were happy with the training and support they received from the management team at Caremark.
People we spoke with knew how to make a complaint to the agency, and we saw evidence that complaints had been dealt with in an appropriate manner.
The majority of people we had conversations with confirmed that they were aware of their care plans and the information they contained and that they were involved in reviews of their care. They all indicated that in the event that they had any queries about their care they felt able to contact the provider and several confirmed that they received occasional visits from the provider to monitor how their care was progressing and/or were asked to complete surveys about their care service.
One person we spoke with said that at times they had a number of different care workers in rapid succession and they had to get used to them and explain how their specific care routine should be completed, which they felt was not ideal.A number of the people we spoke with however said that they thought there had been a recent improvement in the care service that they receive from Caremark Hemel.
People told us that they generally felt able to determine the way that their care is provided to take account of their particular needs and preferences and that overall they received a good standard of care.
When we talked with people receiving a care service about reliability, for example incidence of missed calls or where only one care worker arrived when two were needed, they all agreed that whilst there had been significant problems with this in the past, there had been a marked improvement in recent months and reliability was no longer such a major concern for them.
We did not specifically talk to people receiving a care and support service from Caremark Hemel about safeguarding,although when we did speak with them between November 11 and 15 2011 about their care service in general,none of them raised any concerns with us about their safety or security and one person said during our conversation with them that they felt 'safe and well cared for'.
In our conversations with people who currently receive a care service from Caremark Hemel they told us that their care workers provided a generally effective care service and that they thought they had the necessary skills and experience to meet their care needs. 'They are very efficient' was one persons' comment.
People who receive a care service told us in our telephone conversation with them that, with their permission, staff occasionally carry out observations of care workers in their homes in order to help them monitor the performance and capability of care staff and to discuss their experience of receiving a care service with them.
Each of the people we spoke with said that they felt able to contact the 'office' if they had any concerns about the quality or reliability of their care service and although some of them had previously had problems with communication, they thought that generally this had now been improved.
People receiving a service said that they did not always receive up to date information about who was to provide their care, that they had experienced missed or late calls and that calls were irregular in terms of time and duration, so that they could not rely on the service to meet their needs at all times.
They also said that on some occasions where two care workers are supposed to attend together to meet their care needs only one care worker had been provided.
This could seriously compromise the health, safety and well-being of people receiving a care service.
However some people who receive a care service said that their (individual named carers) provided them with a high standard of care and were caring and attentive to their care needs. (We found that this was most likely to be the case when the care was consistently provided by the same individual or a consistent team of care workers.)