Background to this inspection
Updated
27 May 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 9 and 11 May 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
The inspection was carried out by one inspector. Prior to the inspection we looked at information we held about the service, including notifications the service had sent us. A notification is information about important events that affect the service, which the service is required to send us by law.
During the inspection we spoke to three care workers, a field supervisor and the registered manager. We reviewed five care plans, five medicine administration recording sheets [MARS], four staff files and other documents related to the management of the service.
After the inspection we spoke with three people using the services and two relatives.
Updated
27 May 2016
We carried out this inspection on 9 and 11 May 2016 and the inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
Caremark (Mid–Surrey) is registered to provide personal care to people in their own homes. At the time of the inspection there were 30 people using the service.
The service had a registered manager in place. 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.
People were protected against identified risks. The service had comprehensive risk assessments in place that identified risks and gave guidance to staff on how to minimise the impact of the risks on people. The risk assessments were regularly reviewed to reflect people’s changing needs.
People were protected against avoidable harm and abuse. Staff underwent safeguarding training. They were able to identify the different types of abuse and how these may manifest in people’s behaviours. Staff had sound knowledge of the correct procedure to follow in reporting suspected abuse.
People received their medicines safely and in line with good practice. Staff were aware of the safe procedure for administering, recording and disposing of medicines. Medicine administration recording sheets [MARS] were completed correctly by staff and were audited regularly by senior staff, which meant errors were identified quickly and actions taken to minimise the impact on people.
People were not deprived of their liberty unlawfully. Staff had adequate knowledge of the mental capacity act 2005 [MCA] and deprivation of liberty safeguards [DoLS]. Staff were aware of the correct procedures when supporting people who were unable to make informed decisions and would follow the legal requirements outlined in the MCA and DoLS.
Care plans were person centred and detailed people’s preferences. The service regularly reviewed people’s care plans to reflect people’s changing needs and wishes. Where possible staff encouraged people to make decisions about the care and support they received, which was documented in their care plans.
People’s consent was sought prior to care being delivered. Staff were aware of the importance of obtaining people’s consent and offering people choices about the care they received. Staff recorded people’s choices and informed the registered manager if there were changes to people’s preferences so that records could be kept up to date.
The service recorded incidents and accidents and action plans were in place to address incidents in a timely manner. The service learnt from incidents and accidents to ensure they were not repeated. People were encouraged to raise concerns and complaints. The service had procedures in place to record, review and learn from complaints. Records showed complaints were addressed in a timely manner.
People received care and support from sufficient numbers of staff to ensure their needs were met. The service employed more staff than required to cover staff absence such as sickness and holiday. The service carried out the necessary safety checks on new employees. The registered manager ensured that all staff had received a disclosure and barring services [DBS] check, two references and photo identification prior to commencing employment.
People received support from staff that were skilled and knowledgeable. Staff underwent on-going training to effectively meet people’s needs. Staff completed mandatory training in health and safety, first aid, medicines management and moving and handling. Staff received on-going supervisions and appraisals where they reflected on their working practices.
Staff were aware of the importance of protecting people from social isolation. Staff provided people with companionship calls if agreed in their care packages. Where this wasn’t agreed, staff would inform the registered manager of any concerns relating to social isolation and this was then raised with the funding authority.
The management team monitored the quality of the service through audits to drive improvements. Feedback was sought by the provider through surveys which were sent to people annually. People and relatives we spoke with were aware of how to make a complaint.
People were supported to access sufficient food and drink which met their preferences. Staff were aware of the importance of monitoring people’s food and fluid intake and informed health care professionals and relatives if changes were identified.