Caremark (Oldham) is a private domiciliary care service. The service provides personal care and support in the community to children, younger adults and older people who have a variety of health and social care needs and who live in their own homes. The service currently supports around 80 people.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 been in post since June 2015.

At the last inspection of June 2015 the service were rated as good with a breach of Regulation 12 (1) (2) (g) the safe administration of medicines because the MAR records were not maintained accurately. The service sent us an action plan to show how they were going to make the required improvements. We saw at this inspection that by further staff training and regular medicines audits the service had made the improvements and the regulation was met.

Staff we spoke with were aware of how to protect vulnerable people and had safeguarding policies and procedures to guide them, which included the contact details of the local authority to report to.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults. There were sufficient staff to meet people’s needs.

Risk assessments for health needs or environmental hazards helped protect the health and welfare of people who used the service but did not restrict their lifestyles.

Staff were trained in the administration of medicines and managers checked the records to help spot any errors and keep people safe. Managers also checked that staff were administering medicines correctly to ensure they were competent to do so.

Staff were trained in infection control topics and issued with personal protective equipment to help prevent the spread of infection.

Staff received an induction and were supported when they commenced employment to become competent to work with vulnerable people. Staff were well trained and supervised to feel confident within their roles. Staff were encouraged to take further training in health and social care topics such as a diploma.

People were supported to take a healthy diet if required and staff were trained in how to handle food safely.

The service were of aware of how to protect a person’s rights by following the principles of the Mental Capacity Act.

We observed a good rapport between people who used the service and staff. People were supported by a regular staff team who knew them well.

Personal records were held securely to help protect people’s privacy.

There was a complaints procedure for people to raise any concerns they may have.

People were assisted to attend meaningful activities if this was a part of their support package

Plans of care gave staff clear details of what care people needed. People helped develop their plans of care to ensure the care they received was what they wanted.

There were systems in place to monitor the quality of service provision and where needed the manager took action to improve the service.

The office was suitable for providing a domiciliary care service and was staffed during office hours. There was an on call service for people to contact out of normal working hours.

We spoke with two people who received a service from the agency and representatives (relatives) of three other people. People told us that they were involved in the assessment of their needs and in deciding what care they wanted. One person said “The staff ask what I want”. They said staff respected their wishes and preferences.

People said staff were reliable and they liked that they had the same staff team members at each visit. One person told us they received a copy of the staff rota so they knew who would be assisting them at each visit. People told us that staff were “happy” with the staff support they received. They told us that any issues or concerns were usually dealt with immediately.

The two staff we spoke with demonstrated a good understanding of their individual roles and responsibilities. They confirmed they received training to meet the specific health care needs of people. They confirmed they used protective clothing such as gloves and aprons to minimise the risk of cross infection.

We saw that systems were in place to ensure staffing numbers were sufficient to meet people’s needs.

The quality of the service was monitored and people’s concerns or issues were responded to appropriately.

We spoke to two people who received a service from the agency and relatives who were representatives for three other people. People were overall positive about the service they received and the staff who provided the service.

Comments from people included, “The service is brilliant”; “I tell them [the staff] what I need and they listen to me” and “They [the staff] always ask if there is anything else they can do for me before they leave”.

Comments from relatives included, “We are very happy with Caremark (Oldham). They are helpful and responsive” and “On the whole they are very good. They are very flexible to accommodate changes [such as times of care visits]”. We heard that the agency tried to respect people’s requests regarding the gender and ethnicity of the care worker required.

With spoke with both children and young adults and health and social care commissioners of the service. We were told that the agency was “Very helpful and communication was excellent”. We heard about one instance where an issue had arisen and the agency had responded quickly and appropriately to manage this. We heard that initial feedback from families about the agency was “Good”.

We spoke with three care workers and they told us they enjoyed working for the agency. Care staff were able to tell us about how they met the different needs of both children and older people. They told about the training they received to make sure they were able to care for their “customer’s” care needs.

We undertook an announced inspection of Caremark (Oldham) on 10 and 11 August. The inspection was announced 48 hours prior to our visit to ensure that the registered manager or other responsible person would be available to assist with the inspection.

Caremark (Oldham) is a service that provides care to people within their own home or out in their local community. The main office is situated on the outskirts of Oldham and support is provided to people in and around Oldham. The services provided include personal care, assistance with medication, cooking meals, daily activities and shopping as well as a sitting service for carers. At the time of our inspection 168 people used the service.

The service had a registered manager in post. 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.

Carer’s who had been recently recruited told us they had been through a robust recruitment process. We saw that Caremark’s recruitment and selection policy had been followed in the recent employment of staff. We looked at the training records for all staff including recently recruited staff. Newly recruited carer’s had received induction training when they started their employment. We saw records for carer’s having completed or were working towards a nationally recognised qualification in care (National Vocational Qualification

)

.

Care plans were in place to reflect the needs of the people. This included information about how people wanted to be supported, their likes and dislikes, when support was required, and how this was to be delivered. We saw evidence of people and their relatives being involved in the decision making process throughout the initial assessment and during reviews.

Information regarding people’s dietary needs was included in their care plan, and detailed guidance for carer’s was provided in order to ensure that they met these requirements. Any specific dietary requirements were clearly documented, and all allergies were written in bold so carer’s were aware of any risk.

Carer’s were able to respond to people’s individual needs by following care plans. We spoke with three people who confirmed they received support to access the community for leisurely activities and two people confirmed that their carer’s would accompany them to attend health appointments or request health professionals to visit the home if needed.

People who used the service were also able to raise any concerns if they wished with the management team. We saw evidence that people’s comments and complaints were responded to appropriately.

The systems for managing medicines in the service needed to be improved to ensure that people always receive their medicines as prescribed. We saw evidence that some carer’s had not signed to confirm that they had safely administered medicines, and gaps in medicine administration records had not been explained.

All staff had undertaken training in the Mental Capacity Act (MCA); this legislation provides legal safeguards for people who may be unable to make their own decisions. The registered manager explained that they worked alongside the local authority and would agree people’s capacity to consent to the care and treatment prior to any service being commenced. This was evidenced and documented in the care plans.