Background to this inspection
Updated
29 August 2019
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
The inspection was undertaken by one inspector.
Service and service type
Karosel care is a domiciliary care agency. It provides care and support to people living in their own homes. People using the service received support with personal care including washing, dressing and food preparation. The Care Quality Commission does not regulate premises used for domiciliary care; this inspection looked at people’s care and support. The service had a manager registered with the Care Quality Commission. This means 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
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
Before our inspection we looked at all the information we held about the service. This included any concerns, investigations or feedback. We also checked the statutory notifications the service is required to send to us by law and we looked at the Provider Information Return. 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. This information helps support our inspections. We used this information to plan the inspection.
During the inspection
We spoke with five members of staff including the registered manager. We reviewed a range of records. This included four people’s care records and medication records. We looked at three 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 feedback about the service from people who use the service, and their relatives.
Updated
29 August 2019
About the service
Karosel Care is a domiciliary care agency which provides support for adults in the community, including those living with dementia, who require assistance with personal care. At the time of the inspection, nine people used the service supported by six care staff and a registered manager.
People’s experience of using this service and what we found
Systems were not in place to analyse accidents and incidents. This meant that processes to learn from themes and trends and to mitigate further risk were not robustly implemented. This was an area that required improvement. Staff were receiving support from the manager and received training appropriate to the care and support they were providing. The provider was not following their own policy for staff supervision and appraisal this was an area for improvement. . We did not identify any negative impact for people from this lack of governance. The service was led by a registered manager who everyone described as approachable and exceptionally caring. The culture of the service was open and inclusive.
People were happy with the care they received and felt safe with the staff that were supporting them. The service was safe. Systems were in place to protect people from the risk of abuse and improper treatment and staff knew how to identify potential harm and report concerns. People received their medicines safely from staff who were trained to administer these. Checks were carried out prior to staff starting work to ensure their suitability to work with people who used the service.
People were cared for by staff who were well supported and had the right skills and knowledge to meet their needs effectively. Care records included assessment of risk and staff knew how to reduce the risk of potential harm. People received support from a consistent team who knew them well. There were sufficient numbers of staff to ensure people did not feel rushed and people received their support on time.
People were supported to have maximum control over 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.
Positive and caring relationships had been developed between staff and people who used the service. People were treated with kindness and compassion and staff were friendly and respectful. People benefitted from having support from staff who had a good understanding of their individual needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This service was registered with us on 2 August 2018 and this is the first inspection since registration. We found evidence that the provider needs to make improvements. Please see the well led section of this full report. We found no evidence during this inspection that people were at risk of harm from this concern.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.