Background to this inspection
Updated
7 April 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on the 27 January 2015. This visit was announced, which meant the provider and staff knew we were coming. We did this to ensure that appropriate office staff were available to talk with us, and that people using the service were made aware that we may contact them to obtain their views.
An inspector and an expert by experience in older people’s care undertook this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience helped us with the telephone calls to get feedback from people.
Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make. This enabled us to ensure we were addressing any possible areas of concern and looking at the strengths of the service.
We also reviewed other information we held about the service, and considered information which had been shared with us by the Local Authority, and looked at safeguarding alerts that had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. Before the inspection we spoke with the Local Authority to ask them about their experiences of the service provided to people.
On the day of the inspection we spoke with the manager, the owner, and a co-ordinator. After the inspection we contacted 15 people that used the service and six relatives by telephone. In addition to this we spoke with a further three care staff following the inspection.
Over the course of the day we spent time reviewing the records of the service. We looked at four staff files, complaints recording, accident/incident and safeguarding recording, staff rotas and other records related to the management of the service. We also reviewed four care plans and other relevant documentation to support our findings.
Updated
7 April 2015
We inspected Caremark (Eastbourne & Wealden) on the 27 January 2015. Caremark (Eastbourne & Wealden) is a domiciliary care agency providing personal care for a range of people living in their own homes. These included people living with dementia, older people and people with a physical disability. At the time of our inspection the service supported 29 people and employed approximately 25 staff. Caremark (Eastbourne & Wealden) operates as a franchise business, trading as APC Care Limited. Caremark provide domiciliary care franchises and services across England.
On the day of our inspection, there was no registered manager in post; however a registered manager application had been received by the Care Quality Commission (CQC), which has subsequently been accepted since the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Caremark (Eastbourne & Wealden) has not been previously inspected. We found areas of practice that required improvement.
Where people lacked mental capacity to make specific decisions, the service was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests. However, despite senior staff having appropriate training and knowledge, we found that care staff had not received formal training around the MCA. This is an area of practice that requires improvement.
Quality assurance was undertaken by the provider to measure and monitor the standard of the service provided. However, we found that despite checks taking place, we could not identify how the provider monitored or analysed information over time to determine trends, create learning and to make changes to the way the service was run. This is an area of practice that requires improvement.
Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.
The service had good systems in place to keep people safe. Assessments of risks to people had been developed and reviewed. The service employed enough, qualified and trained staff, and ensured safety through appropriate recruitment practices.
People said they always got their care visit, they were happy with the care and the staff that supported them. One person told us, “They’re very thoughtful, always polite, they’re very good”.
People told us they were involved in the planning and review of their care. We were given examples that showed the service had followed good practice and safe procedures in order to keep people safe.
Staff received an induction, basic training and additional specialist training in areas such as dementia care, nutrition and first aid. Staff had group and one to one meetings which were held regularly, in order for them to discuss their role and share any information or concerns.
If needed, people were supported with their food and drink and this was monitored regularly.
The needs and choices of people had been clearly documented in their care plans. Where people’s needs changed the service acted quickly to ensure the person received the care and support they required. A member of staff told us, “We take notice of any problems with the clients and the office listens to us. One person was having real problems with their hearing aids, so I called the office and they sorted it all out”.
People and their family members told us they were supported by kind and caring staff. A person told us, “I’m happy with the way they look after me, and the way they look after my husband”. Another said “They do what they do very well”. Staff were able to tell us about the people they supported, for example their personal histories and their interests.
People’s personal preferences, likes and dislikes were recorded on file and staff encouraged people to be involved in their care. A person told us, “They’ll do anything I ask them to. If I want to change my time by 10 minutes – no problem”.
People knew how to raise concerns or complaints. People and their relatives were regularly consulted by the provider using surveys and meetings. A person told us, “If something goes wrong, I only have to mention it”.
The manager, along with senior staff provided good leadership and support to the staff. One member of staff told us, “I feel that Caremark are excellent and really supportive”.