We carried out an announced inspection of the service on 17 April 2018. Caremark (Mansfield) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. Not everyone using Caremark (Mansfield) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

There was a registered manager in post at the time of our inspection. 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.

At the time of the inspection, 100 people received some element of support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection, the service was rated as ‘Good’ overall, however the question, ‘Is the service well-led?’ was rated as ‘Requires Improvement’. At this inspection, they maintained the overall rating of ‘Good’. The rating for the question, ‘Is the service well-led?’ improved to ‘Good’. The rating for the question, ‘Is the service effective?’ changed from ‘Good’ to ‘Requires Improvement’. This was because people had raised some concerns that staff did not always arrive for calls on time. We also had concerns that people’s rights were may not be protected when decisions were made for them.

People told us they felt safe when staff supported them. Staff understood how to report concerns about people’s safety to reduce the risk of people experiencing avoidable harm. There were enough staff to support people and the risks to their safety were assessed and acted on. People’s medicines were managed safely. Staff understood how to reduce the risk of the spread of infection. The provider had processes in place to investigate accidents and incidents and to learn from mistakes.

Some people felt staff did not always arrive on time for their calls. People’s care was provided in line with current legislation and best practice guidelines. Staff were well trained and understood how to support people effectively. Staff performance was regularly monitored although the frequency of these supervisions had recently reduced. People were supported to follow a healthy diet and staff supported people effectively with their meals. Information was available to support staff with caring for people. Other health and social care agencies were involved where further support was needed for people. 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 support this practice. Some improvements were required to ensure all people’s rights under the Mental Capacity Act (2005) we respected. .

People and relatives liked the staff and felt they treated them or their family members with dignity and respect. People were encouraged to do things for themselves and were enabled to make decisions about their care. Staff treated people with compassion and communicated effectively with people.

People were assessed before joining the service to ensure their needs could be met. People’s care records were person centred and staff provided them with support in the way they wanted. People felt care staff responded effectively to complaints or concerns raised, however some felt office based staff did not always do so. People’s diverse needs were discussed with them and respected.

The registered manager carried out their role in line with their registration with the CQC. They now ensured all notifiable incidents were reported to the CQC. Staff respecte

We carried out an announced inspection of the service on 12 January 2016. Caremark (Mansfield) is registered to provide personal care to people in their own homes. At the time of our inspection the service was providing the regulatory activity of personal care to 79 people.

On the day of our inspection there was 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 supported by staff who made them feel safe when they were in their home. Regular assessments of the risks to people’s safety were conducted and regularly reviewed. Care plans were in place to address those risks. Appropriate checks of staff suitability to work at the service had been conducted prior to them commencing their role. People were supported by staff who understood the risks associated with medicines.

Staff completed an induction prior to commencing their role and received regular supervision of their work. Staff felt supported by the registered manager and received regular training to enable them to support people effectively.

The registered manager was aware of the principles of the Mental Capacity Act (2005). People were able to make choices and staff respected their wishes.

People were encouraged to eat healthily and any excess loss or gain in weight was reported by staff to the registered manager. People were happy with the way staff supported them with their meals. People’s day to day health needs were met by the staff. Before referrals were made to external health services this was discussed with people to gain their approval.

People told us they thought the staff were kind and caring, treated them with respect and dignity and listened to and acted on their wishes.

People were provided with the information they needed that enabled them to contribute to decisions about their support. People were not currently provided with information about how they could access independent advocates to support them with decisions about their care.

People’s care records were written in a way that ensured their aims and wishes were reflected throughout. People’s records were regularly reviewed. People and their relatives where appropriate, were involved with planning the care and support provided. People were provided with the information they needed if they wished to make a complaint and they felt their complaint would be acted on.

The registered manager led the service well and understood their responsibilities, however, they had not had not always ensured the CQC were notified of incidents that had occurred.

People and staff spoke highly of the registered manager. There were a number of processes in place to gain the feedback of people and staff in order for the service to develop and improve. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.