Caremark Tunbridge Wells, Tonbridge and Malling

On this page

• 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

The management team told us, that they and the service were looking at ways to continually improve. Accident, incidents, complaints or other significant events were logged. However, there was little evidence that actions had been taken in response to analysing the trends and patterns and learning lessons. Systems and processes to audit and check the service were in place, however these were not always robust. Staff did not always feel communication was effective.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us that communication within the service was not good. They said, “Communication is poor, we don’t have staff meetings, there shouldn’t be secrets, we need to know general things. [Manager] said when she started that there would be meetings but it has not happened. They have just set up a [group chat] group, we have not really used it yet. We used to have regular spot checks, we have them very rarely now” and “There has been issues when calls have been added to my rota without asking and I have messaged the office mailbox to explain I can’t do them. They then have removed them but I never get a response.” The management team were clear they wanted to improve the service and outcomes for people.

There was a statement of purpose along with vision statements on the providers website. This showed, ‘Our aim is to provide high-quality care to individuals who require assistance with daily activities due to age, illness, disability, or other conditions. Caremark provides many different types of care services in Tunbridge Wells, which depend on the needs of the individual.’ There was a positive and person-centred culture in the service. Staff had access to people’s care plans and spoke knowledgeably about the people they supported. The provider was not fully meeting their statement of purpose because of the areas of improvements identified during the assessment.

Some staff felt they were not listened to by the management team when they raised issues and concerns. They said, “I feel listened to in the moment and then it’s forgotten about” and “I have reported it a number of times and have now given up.” The management team knew people well and were passionate about making changes to improve people’s lives.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was no registered manager in post. A new manager had started employment but was in the early stages of applying to register. This meant that the provider was legally responsible for how the service is run and for the quality and safety of the care provided. Effective systems were in place to foster good working relationships with community health care teams and the local authorities. These relationships supported people to receive joined up care. People and relatives told us the management team were approachable. Comments included, “I do know who the manager is, sometimes she comes out as a carer to me. I’ve not ever had to do any feedback forms or anything like that but I am really happy with all of them” and “I know who the manager is and do feel that I can communicate with him and will get a response.”

Staff confirmed they were not invited to meetings. Staff meeting minutes evidenced that office based staff met but then the outcome of these meetings had not been shared with the care staff. Care staff wanted the opportunity to meet and to be encouraged to voice their ideas for improvements and any concerns. Most staff knew how to raise concerns with the provider or outside organisations if they needed to.

The provider had systems and processes in place to foster a positive culture where people felt that they could speak up and have their voices heard. Complaints processes were available. However, a relative raised, “There are some improvements that could be made. If you are going to bring in new staff, shadowing is needed and the rotas need more thinking about. Sometimes [loved one] is put to bed at 18:30 and is in bed for 12 hours at least. I have put in a grievance about it but they just say there is nothing they can do.” Another relative said, “I did have an issue last week whereby the rota had not been emailed to me and I rang about it and it was sent the next day which was good. I feel confident about complaining and I do feel that I am responded to.” A person told us, “We have been with them a long time and the manager visits or calls us regularly to ensure everything is going well.”

Staff feedback was mixed, “Managers are always available” and “We have supervisions but nothing gets done, supervisor says I will go away and pass this on. It can be very frustrating.”

There was an equality and diversity policy in place. All staff attended equality and diversity training. The management team worked together well as a team and supported care staff by providing assistance at care visits. The workforce was diverse and support was in place for staff when they had been unwell. Flexible working was in place to support staff.

Staff told us they liked working in the service. Some staff told us the management team were supportive. Some staff did not feel well supported. Some staff we spoke with were confident that they could discuss any concerns with the management team and these would be acted on, they were aware of how to escalate concerns to senior management or outside of the organisation. The management team said, “We appreciate the feedback and it has helped us to look at some other points.”

The provider had an audit programme in place. Although these processes were in place, they were not robust enough to highlight the shortfalls in the service, we found during the assessment. For example, the management team were unaware from their electronic call monitoring data that there were issues with lateness, double calls not overlapping. After the assessment they reviewed their systems and checks and spoke with the company who provided the electronic call monitoring software to try and make improvements. The audits and checks completed on care records had not highlighted that some staff had used their own supermarket loyalty card when shopping. The management team sent us regularly updates to detail the improvements they were trying to make to improve the quality of the service. The providers processes in place to ensure there was an inclusive culture was not robust. Care staff did not always feel communicated with and were not involved with meetings. There was an application that had been put in place to aid communication within the service. Not all staff were aware of it and information shared by the management team showed that it was not used widely to communicate messages about the day to day running of the service. It had been used to communicate messages to staff around birthdays and offers of bonus schemes in relation to staff recommending new staff to the service. The management team met with staff after our assessment to action improvements. Services providing health and social care to people are required to inform the CQC of important events that happen in the service. This is so we can check that appropriate action has been taken. The management team had correctly submitted notifications to CQC. People's personal records were stored securely including on computers and applications on devices, these were protected by passwords, so that only staff who had been authorised to access the information could do so.

People told us, “They are very helpful and will always accommodate any time changes that we may need” and “The staff always talk through what is going on and explain things to us. We have been with this agency for a long time.”

Staff told us they worked with people and their relatives to ensure people received safe care. A staff member told us, “I report changes to people’s care and support needs to the office and they would deal with this, I would also report to the house manager at [partner organisation].”

We received no negative feedback from partners. The local authority commissioning team told us, ‘This is a non-framework provider and not subject to regular contract management. I have checked our Intelligence Log and there have been no issues raised regarding the service being provided.’ A healthcare partner said, ‘Caremark’s staff have been attentive to changes in the health and care needs of the residents they support. They are proactive in identifying when health conditions require additional attention and communicate effectively with [us] and other relevant professionals.’

The provider had systems and processes in place to collaborate and work in partnership with health partners, social services and local authority contracting teams. This enabled them to share information and learning with partners and collaborate for improvement.

The management team told us they had reviewed the feedback we gave them as part of the assessment process and valued this. They were using the feedback to make improvements and put systems in place to embed the changes. The management team said, “We appreciate the feedback and it has helped us to look at some other points.” They explained they had been meeting with staff since our assessment to gain feedback and make changes.

The provider’s systems to learn and improve were not always robust. After the assessment process the manager told us they had ‘I have a clear audit now rolling and I am monitoring it closely.’ The provider had systems in place to gain feedback from people and their relatives about their care and support. A person told us, “The manager is very approachable. She came to see me recently to ask if everything was alright and it is. I have only been with them for a few months but I am very happy with them and have no complaints at all.” Another person said, “I can’t think of anything that needs to be improved. I am very happy.”