Background to this inspection
Updated
12 January 2024
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector and an Expert by Experience. 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, flats and specialist housing.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager had been in post for 5 months and had submitted an application to register. We are currently assessing this application.
Notice of inspection
We gave a short period notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection. Inspection activity started on 28 November 2023 and ended on 6 December 2023. We visited the location's office on 1 December 2023.
What we did before the inspection
We reviewed information we had received about the service. 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 4 people who used the service and 6 members of staff including the care manager, compliance and registration manager and care assistants. We also spoke with the nominated individual The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 3 relatives about their experience of the care provided. We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
Updated
12 January 2024
About the service
Caremark (Broxtowe & Erewash) is a domiciliary care agency providing the regulated activity of personal care. The service provides support to adults of all ages, people living with dementia, and people who have learning or physical disabilities. At the time of our inspection there were 123 people using the service.
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 the service and what we found:
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
Right Support
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; however the policies and systems in the service did not always support this practice. We have made a recommendation the provider reviews people’s mental capacity assessments and best interest decision documentation.
Right Care
The service was not able to fully demonstrate how they were meeting some of the underpinning principles of Right Support, Right Care, Right Culture. The service had not always ensured staff had the skills, knowledge and experience to deliver effective care and support. We found care plans to contain personalised information on risks which affected people's daily lives. People were supported to receive their medicines safely and there were sufficient numbers of suitable staff.
Right Culture
The provider did not have an effective governance system in place to identify issues we found on inspection. However, the provider promptly addressed our findings and sent us an action plan. People and staff spoke positively about the culture of the service and the service had supported people to achieve positive outcomes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good published 10 September 2018.
Why we inspected
This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe, and well-led. During the inspection we found there was a concern with mental capacity assessments and staff training so we widened the scope of the inspection to include the key question effective.
For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Enforcement and Recommendations
We have identified breaches in relation to staffing in respect of training and the management of governance systems at the service. We have also made a recommendation that the provider reviews people’s mental capacity assessments and best interest decision documentation.
Please see the action we have told the provider to take at the end of this report.
Follow Up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.