Caremark Brent

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Systems were in place to investigate accidents, incidents, complaints, and safeguarding incidents. There was a system in place to manage medicines. Systems were in place to recruit staff. There were enough staff to meet people’s needs. An electronic system was in place to monitor staff timekeeping and punctuality. The majority of risks to people were identified and managed. Staff had completed training and received ongoing support. Systems were in place to help prevent and control infections. Management communicated and worked with other agencies to help keep people safe.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us they felt able to openly speak with staff and management. They were aware of the complaints process and felt that their concerns would be listened to and addressed appropriately.

Management promoted a culture of learning within the service to help staff learn and improve practice. Lessons learnt were discussed in meetings and staff were encouraged to openly discuss and learn from one another.

Policies and procedures were in place for investigating, analysing, and responding to accidents, incidents, complaints, and safeguarding alerts. Staff were encouraged to report incidents.

Relatives told us they were informed and involved in people’s care and support planning.

We did not receive feedback from staff regarding this aspect of the service.

We did not receive feedback from external partners.

There was a referral and admission process in place so that people received joined up care.

The majority of relatives told us they were confident their family members were safe in the presence of care staff and raised no concerns. A relative told us, “The carers are considerate and they interact well with [my family member] and [family member] is happy,”.

Staff told us they felt confident reporting concerns and wouldn’t hesitate to do so. Care staff were able to describe the action they would take if they witnessed or suspected any abusive or neglectful practice. They were confident that management would take appropriate action when required. The manager was aware of their responsibilities on how to help protect people from abuse and the actions they would take where there was an allegation of abuse.

Safeguarding procedures were in place. These provided guidance about the action to take if staff had concerns about the welfare of people. Training records showed staff had completed safeguarding training.

The majority of relatives we spoke with were confident risks were managed and their family members were supported to remain safe.

Staff told us how they supported people safely to protect them and reduce the risk of harm. Staff we spoke with told us they wouldn’t hesitate to raise concerns with management and had confidence that the appropriate action would be taken.

The majority of risks to people were identified and managed to help keep people safe. Risk assessments covered various areas such as the environment, falls and transfers and included detail about the level of risk and information about control measures in place. However, we found examples where there was not a personalised risk assessment in place for some specific health issues. For example, 1 person was diabetic but did not have a personalised risk assessment in place for this. Another person had previously had a stroke and there was not a personalised risk assessment detailing the signs to look out for and how to mitigate this. We raised this with the manager who acknowledged this and amended risk assessments to include these potential risks.

CQC does not assess people’s home environments for this type of service. However, we were able to see the provider had carried out an assessment of people’s homes to help identify risks. Where they had identified risks, they had liaised with families to help ensure the environment was safe.

Management explained that during the assessment of people’ needs, they looked out for hazards and if these were identified, measures were put in place to reduce the risks of harm to people. For example, staff checked for hazards in the bathroom before supporting a person with a shower or bath. This helped to support people in a safe environment.

Processes were in place to help ensure risks within the environment were assessed and monitored.

Relatives spoke positively about care staff and said staff were punctual. A relative told us, “This care agency and the staff are superb.” Another relative said, “My [family member] has complex needs and is not easy. The carers are knowledgeable and kind and always arrive with a smile on their face.” People received continuity of care. Care and support was provided by a stable and regular workforce that people were familiar with. This helped people and staff develop positive meaningful relationships.

Staff told us there were enough staff to safely meet people’s needs. Staff spoke positively about communication within the service and said they were kept informed of changes and developments. A member of staff said, “There is good communication in the agency. I can ask questions.”

Policies and procedures were in place to help recruit staff safely. Checks on the suitability of potential staff were completed. This included obtaining references and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and help prevent unsuitable people from working in care services. Records showed that staff had received training in areas relevant to their roles. Staff received supervision sessions which provided an opportunity for them to discuss their performance and professional development. An electronic homecare monitoring system was in place. This monitored care worker’s timekeeping and punctuality in real time. The system would flag up if care staff had not logged a call to indicate they had arrived at the person's home and were running late. If this was the case, staff in the office would receive an automatic notification and the office would call care staff to ascertain why a call had not been logged and take necessary action there and then if needed.

Relatives told us that staff followed good infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE).

Staff told us they had training and information about infection prevention and control. Staff said they had enough PPE. Staff understood infection, prevention, and control procedures.

Infection prevention and control policies were in place. Staff completed infection prevention and control training. They were given the information and guidance they needed.

Relatives told us people were appropriately supported with their medicines.

Staff had their competency to administer people’s medicines safely assessed to ensure they had the skills and knowledge to do so. Staff told us they knew how to report medicines incidents and felt confident in doing so.

A medicines policy and procedure was in place. People’s medicines support needs were documented in their care plan. Care staff recorded medicines administration electronically so that the manager could monitor this in real time. We looked at a sample of Medicines Administration Records (MARs) and found that the majority of these were completed fully with no unexplained gaps. We noted there were some instances where medicines had not been administered and staff had documented this with the appropriate key but had failed to record further detail as to why the medicines had not been administered. We raised this with the manager who advised that staff would receive refresher training covering this. A person was prescribed PRN (as required) medicines for paracetamol. However, at the time of the site visit there was not an appropriate protocol in place for staff on when and how to administer PRN medicines. We raised this with management and they implemented an appropriate PRN protocol for this person.