Caremark (Slough and South Bucks) is a domiciliary care agency providing personal care to people in their own homes. This included older people; younger adults; people with learning and physical disabilities and people mental health illnesses. During our inspection there were 46 people using the service.

The registered manager has been in post since August 2013. 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 and associated Regulations about how the service is run.

This is the first inspection of the service under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were happy with the care and support received. They described staff as patient, kind and friendly. Positive relationships were developed because staff knew and understood people’s histories, likes, preferences, needs, hopes and goals. This enabled the service to provide person-centred care which was reflected in care records reviewed. People were able to make and influence decisions about their care. We noted care records clearly captured people’s expressed views on how they wanted their care to be delivered.

People were protected from the risk of harm because staff were fully aware of their responsibilities in regards to safeguarding. Safe recruitment procedures were followed and where there were identifiable risks, appropriate risk management plans were in place.

People received care from staff who were competently trained and skilled to look after their care needs. For instance one person commented, “You can tell they’re (staff) very professional in the way they carry out their work.” This was supported by our discussions with staff and reviews of their training, supervision and appraisal records. Staff worked in line with the law when providing care and support to people who were unable to make specific decisions. Care records showed good examples of staff working in collaboration with other health professionals to ensure good health outcomes for people.

People and their relatives were able to contribute to the assessment and planning of their care. They spoke positively about their interaction with staff before taking on care packages and confirmed they received appropriate information. One person commented, “There was my mum, dad and a supervisor. They really got the care package right.” This ensured the care and support delivered reflected what people said they wanted. People’s care needs were reviewed for their effectiveness and changes to care were made if required.

The service supported people to follow their interests and to take part in social activities of their choice. One person commented, “If I decide I want to go somewhere, as long as I give them (staff) notice they will arrange it. I like going shopping.” This meant their social needs were met.

People gave positive feedback about the service and felt it was well-led. This was supported by staff who were positive about the management and the leadership of the service. Regular staff team meetings took place in order to ensure people’s welfare and safety was protected, staff understood their responsibilities and best practice was shared. We found quality assurance systems in place ensured the service’s audit and governance systems were effective.

People were involved in making choices about their care. People we spoke with told us staff treated them with respect and supported them to make their own choices. Staff had knowledge and understanding about people’s choices and the right to refuse their care and support. We found people's privacy, dignity and independence were respected.

We looked at people's records and spoke with staff. Documentation about support and care needs were detailed and care and support was planned and delivered in line with their individual needs. Care was planned with the involvement of the people who use the service and their relatives.

Systems were in place to identify abuse, take swift and correct actions to eliminate it and report to appropriate professionals. People who use the service and/or their families told us they felt their relatives were safe with the staff. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

A system of staff supervision and appraisal, and day to day communications was in place to support workers. There was training available to support and enable staff to deliver care and treatment to people safely and to an appropriate standard.

The provider had systems in place to monitor the quality of service provided. Documentation we looked at showed feedback from people using the service and/or their families and quality monitoring visits were acted upon to improve the service. There were processes in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.