We carried out a review of the data available to us about Clark James HomeCare - Norwich on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Clark James HomeCare - Norwich, you can give feedback on this service.
People’s experience of using this service:
People who used the service and relatives were positive about the service provided. One person told us, “I get all the help I need, [the staff] are caring and kind.” One person’s relative said, “This service is brilliant, I haven’t had any reason to complain. [The staff] know [my relative] so well and they get on so well with everyone.”
Staff supported people to keep safe and acted when necessary to prevent any harm or abuse. People were supported to have maximum choice and control of their lives, risks to people’s health and wellbeing were managed in a way that did not restrict them unnecessarily. People were supported by staff who were skilled, highly motivated and caring.
People were supported to have their medicines as they prescribed. If needed, people were helped to eat and drink enough to maintain a healthy diet. Staff protected people from the risk of infection by using the necessary protection, such as gloves and aprons.
Care plans were person centred and people were consulted over their care needs and actively encouraged to make their own decisions. Staff were responsive in identifying and reviewing changes to support good physical and mental health.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service confirmed this practice.
Staff received the training and support they needed to carry out their roles. The service worked to ensure that people received person centred care when they used and were supported by different services.
Staff who spoke with us talked about the people who use the service in a caring and positive way. The people who used the service told us that staff were kind, caring and protected their privacy and dignity. We saw evidence that people were able to express their views and staff listened to what they said and took action to ensure their decisions were acted on.
People received care that was personalised and responsive to their needs. The service listened to people’s experiences, concerns and complaints. They took steps to investigate complaints and to make any changes needed.
The service was well led, the registered manager was knowledgeable and well informed. Quality assurance systems were in place and were robust in all areas.
Rating at last inspection: The service was rated as Requires Improvement at its last inspection. (Published on 9 June 2018) This was because although there were quality assurance systems in place, these were not fully effective and further improvements were needed to monitor medicines administration. We also found that further monitoring was needed of the care plans in terms of ensuring that they contained staff guidance in relation to people's health conditions. The regular quality assurance systems had not been robust enough to identify these shortcomings in the care planning documents.
Why we inspected: This was a planned inspection based on the previous rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This was an announced comprehensive inspection which took place over two days. We gained feedback from people on the phone on 19 April 2018, and followed this up with an inspection visit to the provider’s offices on 23 April 2018.
There was not a registered manager in post, and the provider had not had a registered manager in post since May 2017. 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. This meant that there was not a manager who was legally responsible for the service. There was a manager in post who was beginning their registration process with CQC, and they will be referred to as ‘manager’ throughout the report.
There were auditing systems in place, and some of these required further improvement to maintain oversight of the records, and therefore the care being provided. Audits relating to the administration of medicines were not fully effective as they did not identify all gaps or errors in records. The care plans required additional detail in relation to people’s health conditions and associated risks. There was a risk that staff could not always mitigate risks to people because there was not always guidance in place relating to risks associated with their health needs.
People felt safe when staff were with them, and staff had a good knowledge of how to contribute to keeping people safe. There were enough staff to deliver the service as planned, and they were recruited safely.
Staff were trained in areas relevant to their roles and their competency had been checked. They undertook supervisions and discussions about their roles with senior staff. New staff shadowed experienced staff before delivering care to people on their own.
Where it was part of their care delivery, staff supported people with their meals and to drink enough throughout the day. Staff understood how to support people with special dietary needs. If needed, staff also supported people to access healthcare.
People’s daily care needs were assessed before the service supported them, and these were written into a care plan which involved people and the families. Care plans included details of what was expected from staff during the visits, and included people’s preferences.
Staff asked for consent before delivering care and respected people’s choices, supporting them to make decisions when their mental capacity was variable. People and staff had positive relationships and staff got to know people well. The staff including the management team were caring towards people.
People’s dignity was upheld during personal care and staff respected people’s privacy. The service supported people’s independence in different ways, from personal care to supporting people to go out, and this was identified in care plans.
The service responded to people’s changing needs and communicated within the team about these. People’s preferences during visits were adhered to. When people or their relatives raised concerns or complaints, the management team and staff worked to resolve these.
There was good teamwork and support among the staff. The service was striving to make improvements and gained feedback from people in order to take action to improve.
Clark James Norwich Limited provides domiciliary care to around fifty people living in their own homes, some of whom may be living with dementia or long term conditions.
At the time of our inspection the manager had submitted an application to become registered with the CQC. This was approved the day after our inspection and the manager is therefore referred to throughout this report as the registered manager. 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.’
People were supported by staff who were knowledgeable in their roles and demonstrated the skills required. They had been safely recruited and well-trained. Staff had been selected for their diverse skills and abilities. They told us they felt supported and happy in their roles. Staff showed passion for the people they cared for and the service they provided.
Staff demonstrated they understood how to prevent and protect people from the risk of abuse. The service had procedures in place to report any safeguarding concerns they may have and staff understood these. Staff had knowledge of other agencies they could go to report incidents of suspected abuse. People and staff were protected from harm as the service had identified and assessed any risks to them and reviewed these on a regular basis. Risk assessments were individual to the person and their environment.
Medicines were administered in a consistently safe manner. Medicines administration records were clear and accurate and contained relevant information. Where medicines were not administered this was fully documented. Staff understood safe procedures for administering medicines.
Staff received training, regular support and encouragement to further improve their skills and knowledge. Staff were undertaking qualifications and were given regular opportunities to discuss their performance with the management team. The competencies of staff were regularly assessed and recorded to ensure an appropriate standard of care was delivered.
People benefited from staff who felt valued by the service and were happy in their work. They felt listened to and involved in the changes that occurred. They had confidence in the management team and were positive about the changes the service was making.
People were treated in a respectful, compassionate and caring manner. They told us they felt in control of their lives. Staff demonstrated that they understood the importance of promoting people’s dignity, privacy and independence. They gave examples of a caring and empathetic approach to the people they supported.
The CQC is required to monitor the Mental Capacity Act (MCA) 2005 and report on what we find. Staff had received training in the MCA and demonstrated they understood the importance of gaining people’s consent before assisting them.
Care and support was delivered in a person-centred way as the service had completed thorough assessments of people’s needs. People received individualised care as their care plans had been developed in collaboration with them. The service regularly reviewed people’s needs and made changes as required.
Staff assisted people, where necessary, to access healthcare services. Staff had a good understanding of people’s healthcare needs and demonstrated they had the knowledge to manage emergency situations should they arise.
Where required, staff supported people to maintain their interests and avoid social isolation. The service arranged events for people who used the service to aid this. They had made links with the community and worked jointly with other professionals to maintain people’s well-being.
The management team demonstrated an inclusive approach to the management of the service and people had confidence in them. They were supportive, accessible and actively encouraged people to comment on the service they provided.
Complaints were taken seriously and responded to in good time. The management team used them to develop and improve the service. Although people had not felt the need to complain they would feel comfortable in doing this. Effective systems were in place to monitor the quality of the service and the registered manager had identified areas for improvement and was working towards these.