Caremark (Mid Sussex and Crawley)

Updated 26 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 27 March 2018 and ended on 11 April 2018. It included visits to people’s homes on 11 April 2018 where we observed the care provided to people and the records held in their home. The inspection was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. We visited the office location on two separate days, the 27 March and 11 April 2018 to see the registered manager and office staff; and to review care records and policies and procedures. We also attended a community event coordinated by Caremark (Mid Sussex and Crawley) to raise awareness of people living with Parkinson’s Disease on 11 April 2018.

The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service and of people living with dementia. The expert made telephone calls to the relatives of five people who received services from Caremark (Mid Sussex and Crawley) to seek their views of the service. These people chose not to speak directly with the expert and were happy for their relatives to speak on their behalf. The expert also spoke with five people who received care and support from this agency.

We spoke with the registered manager who was also one of the registered providers for this service. We also spoke with the second registered provider, the newly appointed community relations and marketing co-ordinator, a field care manager and a field care supervisor, the recruitment and retention manager and three office based co-coordinators each allocated to covering one of the areas where care is provided to people which included, Crawley, Burgess Hill and Haywards Heath. Four care and support worker staff were spoken with. We spoke with people and their relatives who attended a community Parkinson’s awareness event provided by the agency.

Records were reviewed for four staff and four people using the service.

Before our inspection we reviewed the information we held about the service. We reviewed notifications of incidents that the provider had sent us since their registration. A notification is information about important events, which the service is required to send us by law.

We reviewed the information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We also spoke with a medical and a healthcare professional, and social services representatives views of the service were obtained as part of the inspection process.

Updated 26 June 2018

This inspection took place on the 27 March and 11 April 2018 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. This service was previously inspected on 27 October 2015 and was rated as ‘good’ in all five ‘key question’ domains of ‘safe, effective, caring, responsive and well-led’.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to people with varying levels of need, including older people, younger adults, people living with dementia and mental health, eating disorders, substance misuse problems, learning disability, physical disability and sensory impairment.

There was a registered manager at this service. 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. The registered manager was also one of two registered providers for this service.

Caremark (Mid Sussex and Crawley) provides personal care services to people living in the Haywards Heath, Burgess Hill and Crawley areas. Companionship and domestic support can also be provided. Not everyone using this Caremark service received 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. At the time of the inspection, 147 people received a service from the agency.

This agency provided an extremely personalised and innovative service to people living in their own homes in the community. As well as the more traditional care at home service provided to people, the local social services department had funded a six month pilot for a new responsive model of care called ‘Patch Care’. This new model of care had been created and designed by the Caremark Franchise and taken to the local social services department to fund the pilot project. This service provided an innovative and exciting new model of care with a more tailored approach to care than most traditional care at home services. People and staff included within the new pilot enjoyed the benefits of a more flexible service that responded to individual needs at variable times when people really needed and wanted the support. People were actively engaged and involved in shaping the service provided by this agency and the new ‘Patch Care’ pilot involved people and aimed to tackle the issue of loneliness and social isolation for people.

The agency was engaged very proactively and positively with community organisations in support of people and their relatives living with Parkinson’s Disease. On World Parkinson’s Day the agency worked closely with local Parkinson’s Society representatives to organise a community event which was attended by over 25 people and their relatives, as well as staff and the management of the agency. We also attended this event and observed the positive benefits for people.

People were supported by a very caring staff and management team who demonstrated kindness and compassion towards people, their relatives and their colleagues alike. Staff were reported to have helped people to maintain their independence and also supported a person to regain their confidence to walk again with staff support, dedication and positive encouragement. There was a very evident person-centred culture throughout the agency with staff who demonstrated real passion and dedication towards people and towards each other. People and their relatives were without exception extremely positive and happy with the service they received and people told us that staff were very caring and that they were treated with dignity and respect. A relative told us, "The care they [staff] give is 100% and more. They do a fantastic job."

People were safeguarded from abuse and harm with safe systems and practices. Staff knew how to report safeguarding concerns and received training to enable to do so effectively. People received a personalised service with their needs and risks being assessed by competent staff. Corrective actions were taken to minimise and reduce risks as required. There were enough staff to meet the needs of people safely. Technology was used effectively to schedule visits to people in their homes and people received copies of the staff rota so they knew which staff would visit them.

Staff knew people very well and people received care from staff who had undertaken training to be able to meet their individual needs and preferences, which included having enough to eat and drink. People and their appropriate representatives were involved in the care they received. Healthcare was accessed by staff in a timely manner when people required access to healthcare professionals. Staff were recruited safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.

People received medicines in a safe way from suitably trained and competent staff who were regularly supervised and observed in practice which ensured their continued safety to manage medicines safely. Red medicines folders held within people’s homes provided a clear system for those who received medicines support form staff to have this need met safely. Staff protected people from the risk of infections by using personal protective equipment. Staff had a good supply of protective equipment which they could obtain from the main office, as they needed it. People told us that staff always used the protective equipment appropriately.

At the time of this inspection, the agency did not actively support people at the end of their lives. Records for people demonstrated that their wishes or best interests decisions had been recorded which ensured that people would receive appropriate staff support and intervention at the end of their lives.

Systems and processes were used effectively to monitor the quality and safety of the service. People and their relatives knew how to make a complaint should they need to. Complaints were addressed and handled appropriately and promptly to the satisfaction of the complainant.

The service was exceptionally well managed with an open, approachable, passionate and friendly management team who were all dedicated to working towards providing positives outcomes or people and their relatives as well providing compassionate and team support to their colleagues. The management team were very proactive in their approach and continuously strived to better the service by working with external agencies and commissioners and by maintaining their knowledge of industry best practice initiatives through attendance and involvement at external events. The registered providers, one of whom was also the registered manager for this service had been awarded ‘The Mark of Excellence’ from the Chief Executive Officer (CEO) of the Caremark franchise group, in January 2018. This award stands for excellence demonstrated across the board, which included the quality of service, recruitment and support of staff. The CEO stated that the service’s registered providers had demonstrated that, “with a can-do and highly positive attitude they [registered providers] have built a care team who share their vision. They are champions for the care sector at large”. There were clear aims and objectives of the service with an understanding and management attention to the overall strategy and running of the business.