Background to this inspection
Updated
27 May 2021
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
This inspection was carried out by two inspectors 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 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. Inspection activity started on 25 March 2021 and ended on 07 April 2021. We visited the office location on 01 April 2021.
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, Healthwatch England and professionals who work with the service. Healthwatch England is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service and three relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, senior staff, care workers and care co-ordinators.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with three professionals who regularly visit the service.
Updated
27 May 2021
About the service
Caemac Investments Limited is a domiciliary care agency providing personal care to people living in their own homes or flats. The service was supporting seven people at the time of this inspection.
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 starting to be assessed by the palliative care team but had not yet had their end of life wishes assessed or recorded in care plans. This was an area the provider had previously been asked to review and implement but had failed to do so.
People had been asked about their likes and dislikes and preferred approaches for staff to support them, but this was not always recorded in their care plans. There was a lack of provider oversight in care records to ensure quality was consistent.
People told us they felt safe because they had regular teams of staff supporting them, had not experienced any missed care visits and were happy with the care provided.
People were supported by a staff team who had received all relevant training and understood how to keep people safe and escalate any concerns.
People and their relatives felt able to raise any concerns with the provider and were satisfied that these were acted on immediately and resolved.
Staff were trained in how to work safely within COVID-19 restrictions. People told us they were reassured that staff always wore the correct safety equipment such as gloves, masks and aprons and washed their hands regularly.
People said that staff were caring, thoughtful and helpful if anything changed.
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 supported this practice.
People told us they were regularly asked for their views about the care and were supported by staff to access other healthcare professionals when they needed this.
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 23 December 2019). 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 in some areas and the provider was no longer in breach of some regulations. However, not enough improvement had been made in other areas and the provider was still in breach of the associated regulation.
The service remains requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We have found evidence that the provider needs to make improvements. Please see the responsive and well-led sections of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Caemac Investments Limited on our website at www.cqc.org.uk
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to the planning and recording of person-centred care and the registered managers oversight of some areas at this inspection.
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.