Caremax Homecare Services Limited

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified a breach of regulation during this assessment of Well led. Governance and oversight systems were not always effective, and the provider failed to demonstrate they had a system in place to effectively monitor people’s visits. Concerns were identified about the call monitoring system and the provider’s oversight. The provider had not assured themselves that staff had the required training needed to support people safely. Not all staff had received practical manual handling training, catheter care training and stoma care training. Senior staff were providing practical training for staff but had not received the training necessary to deliver this training. Risks were not always considered or mitigated, staff were carrying out tasks for people without appropriate training and support. Recruitment processes required improvement and support provided to staff was inconsistent. We received mixed feedback from people and relatives about the management of the service. A relative told us, “I think the carers are not well managed. The management of the rota, timings and continuity is dire.” Another relative said, “I think the carers need medication training and the management needs to improve. The team leaders don’t seem to have any management skills and I doubt they have received any training. I would recommend them, but more training is needed across the company.” Other people and relatives were more positive. A person told us, “I wouldn’t change anything. I would recommend them.” A relative said, “The company is well organised, and I have good rapport with the manager. There is good communication with the carers.”

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff had received training on equality and diversity. However, processes in place to share information with staff were limited. Whilst managers meetings were in place, staff told us there were no general staff meetings. Staff told us some information was shared via a group chat but staff messages on this chat did not always receive a response.

The workforce and people they supported were all comprised from a diverse demographic. We received mixed views about the culture of the service. A staff member told us, “I respect all clients cultures and religions and the service supports this.” Another staff member said, “Staff morale is low. We get the occasional message from managers to say we are not contactable, there are no alternatives so assume I would call senior if I needed help.”

Whilst there were processes in place for supervision, appraisal and spot checks. The feedback from staff meant we were not assured these processes were consistent and effective. Most of the staff we spoke with told us there were no staff meetings or had not been any for a long time. Similarly, there were processes in place to support staff to have the freedom to speak up and a whistleblowing policy in place, however we were not assured these processes were consistent or applied effectively.

There was mixed feedback about the support staff received. A staff member told us, “They do not listen to us, they ignore our WhatsApp messages, so we do not feel able to speak up. Who is the manager? We might get a message saying managers are in a meeting, but I am not sure who the overall manager is.” Another staff member said, “I appreciate the supportive management and leadership at Caremax Homecare.” Not all staff were confident to raise issues with the senior team. A staff member said, “I tell them we have no travel time, whatever we say they do nothing.” Another staff member told us, “I only speak to the senior as we get nowhere with office staff. We have a group chat, and messages are put on there, but the messages are ignored.” However, other staff told us they were confident to raise issues. A staff member told us, “I feel encouraged to speak up about any concerns regarding care quality, and I would receive support from management if I were to do so.” Another staff member said, “I am encouraged to speak and up and share my ideas.”

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

There was mixed feedback from staff about the way the service was managed. A staff member told us, “Our clients seem to be very happy with the service. I would be happy to recommend this service for people.” Another staff member said, “I think it is awful, unorganised, there are no procedures, they expect staff to cover their own shift even if you are sick.”

The providers' quality assurance systems in place were not effective in monitoring staff performance, training and support. The provider's auditing and monitoring of people's care calls was ineffective. The system for monitoring calls showed calls overlapping, sometimes duplicating as happening at the same time and a lack of travel time between calls and whilst we saw the rota’s did provide some breaks between calls, other calls provided no time for staff to get to the next visit. We were not provided with any information during the assessment that demonstrated the registered manager had identified these issues. The provider’s policy identified the electronic monitoring system was able to allocate adequate travel time between clients. Starting from 5 to 15 minutes or more if needed, depending on distance from one client to another. However, in practice staff told us this was not always happening. Following our assessment the registered manager told us they were introducing travel time between all calls. We were not assured the providers oversight of training was effective, staff had not received specific training to meet people’s needs or manage associated risks with people’s care and support.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.