Caremark Bristol is a domiciliary care agency registered to provide the regulated activity of personal care. They provided care and support to people in their own homes. The service was currently provided to people in the south of Bristol but were looking to develop in to the central Bristol area. This was the first inspection of this service since they registered in August 2016.

The inspection was announced. We gave the registered manager 48 hours notice of the inspection. We did this to ensure key staff were available for the inspection. At the time of the inspection the service was providing personal care to 41 people and employed 23 care and support workers. There were an additional seven management staff including two directors.

There was a registered manager (one of the directors) in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

The service people received was safe. There were effective safeguarding systems in place and all staff had received safeguarding training. Staff knew what to do if safeguarding concerns were suspected or witnessed or they had been told about something concerning. There were safe recruitment procedures in place to ensure unsuitable workers were not employed. Any risks to people’s health and welfare were assessed and management plans put in place to reduce or eliminate that risk. There were sufficient numbers of care and support workers employed to meet people’s needs. The service was actively recruiting more staff in order to be able to grow the business.

Where people were supported with their medicines this was done safely. Staff received safe administration of medicines training and their competency to support people properly was reviewed. The staff took appropriate measures to prevent and control any spread of infections.

The service was effective. People’s care and support needs were assessed prior to a service being delivered. This was to ensure the service had the capacity to meet their specific care needs and the staff had the necessary skills. The care and support workers were well trained and had regular supervision sessions with the registered manager.

People were supported with meal preparation where this had been identified as one of their care and support needs. The care and support workers monitored those people where the risk of malnutrition and dehydration had been identified. People were supported to access any health care services they required.

People’s capacity to make decisions for themselves regarding their care and support was assessed and kept under review. The staff were aware of the principles of the Mental Capacity Act 2005 and understood their roles and responsibilities in supporting people to make their own choices and decisions.

People received a caring service. The care and support workers treated people with kindness and the feedback we received from people was overwhelmingly positive. People were treated with respect and dignity and the staff team were expected to deliver a service of the highest standard. People were involved in planning the care and support they received.

The service was responsive and provided each person with a person centred service. Staff providing care and support were familiar to people and knew them well. This because there was continuity of care and only one or a small number of staff delivered their support. Feedback was gathered from people regarding their views and experience of the service they received. Action was taken if people had complaints or concerns. The service made changes to improve car