This inspection took place on 27, 28 March and 6 April 2018. At the time of the inspection there were over 600 people receiving a service of around 7200 hours and 15400 visits each week. Around 370 care support workers were employed by the service who received support from field care supervisors. In addition to this, care coordinators, training manager, training administrator, administrators, person centred care administrator, community liaison officer, compliance manager and the registered manager were based at the agency office.

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing. It provides a service to older adults, people with; dementia, mental health, learning disabilities or autistic spectrum disorder or people who misuse drugs and alcohol.

This service also provides care to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a manager in place who was registered with the Care Quality Commission (CQC). 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.

Systems were in place for the safe management and administration of medicines.

The service had followed their policies and procedures when recruiting new staff however, recording of some information needed to be more robust.

We saw there were sufficient numbers of staff employed to meet people's individual needs, however, additional cover arrangements when people left, were on holiday or off sick required improvement to ensure consistency for people.

Staff received training on safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm. Most staff had basic understanding of their responsibilities under the Mental Capacity Act.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People expressed satisfaction with the support they received from staff. The feedback we received confirmed people had positive relationships with staff and felt they genuinely cared about them.

Staff told us they were well supported by their supervisors and the management team. They received a structured induction programme when they were new in post and regular refresher training. This included training on the administration of medicines.

There was a record of any accidents or incidents involving both people who received a service and staff. This allowed the provider to monitor whether any patterns were emerging or if any improvements to staff practice were required.

There was a complaints policy and procedure made available to people who received a service and their relatives. Complaints records showed any complaints received had been investigated and people had been informed of the outcome.

The service sought feedback from peopl

Caremark is a domiciliary care service operating from offices on a business park in Hessle, in the East Riding of Yorkshire and also close to the city of Hull. It provides care and support to adults of all ages with a wide range of care needs, including memory impairment, old age, learning disability and physical disability, as well as some needs associated with medical conditions. There are over 650 people receiving care and support, and around 360 staff working for the service providing 6000 visits per week.

The inspection took place on 28 July and 5 August 2016. 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 at the agency office who could assist us with the inspection. At the previous inspection completed in March 2014 the service was complaint with all the regulations in force at that time

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

The registered manager had not informed the CQC of all significant events as required by regulation. This meant we could not check that appropriate action had been taken. This was a breach of Regulation 18 of the Registration Regulations 2009.

We found that staff had a good knowledge of how to keep people safe from harm and there were enough staff to meet people's needs. Staff had been employed following appropriate recruitment and selection processes. However, DBS checks had been missed for two care workers who were recently employed by the agency. We have made a recommendation about this in the report.

We found that people's needs were assessed and risk assessments put in place to keep people using the service and staff safe from avoidable harm. We found that the administration of medicines was being audited; however, we identified that some recording issues had not been followed up, although the service had implemented a system to address this.

We saw that staff completed an induction process and they had received a wide range of training, which covered topics including safeguarding, moving and handling, first aid, infection control and an introduction to dementia. Staff told us they felt well supported; they received supervision and attended ‘patch’ meetings. Staff were also encouraged to complete the NVQ/QCG Level 2 in health and social care or higher. Staff received training on the Mental Capacity Act 2005 and had knowledge on this topic sufficient for their role. Staff told us they felt well supported; they received supervision and attended ‘patch’ meetings.

Some people told us they received support from staff with shopping, cooking and domestic tasks. They were involved in choosing what items they wanted staff to buy or what they wanted to eat and were generally satisfied with the meals prepared. People were supported to access healthcare support where necessary.

People told us that staff were caring and that their privacy and dignity was respected by the agency’s staff. People’s independence was promoted and most people said they received care from a regular group of carers. People were supported to access the community when this was included in their care plan.

We saw that people's needs were assessed and care plans put in place to enable staff to provide responsive care and support. People had been involved in the planning of their care and relevant people were included in care plan reviews.

People were supported to make choices and decisions and to feedback any concerns. There were appropriate complaints