Harlow-based care company told it “requires improvement” following inspection
Health / Tue 21st Nov 2023 at 11:35am
A CARE company based in Harlow has been told that it “requires improvement” following a CQC inspection.
The Care Quality Commission (CQC) inspected Caremark (Harlow and Epping Forest in October 2023.
Their main office is in Circle Line House, East Road,, Harlow. The report states they are provided and run by Oasis Care-UK Limited.
Here are highlights of the report. The full report can be food by clicking below.
Using medicines safely
● People’s medicines were not always managed safely. The registered manager told us they recorded when medicines were given on a medicines administration record (MAR). However, we found staff had signed that a cream had been applied to a person on 5 different days, but staff had previously recorded, the cream had not been available.
● Additional concerns were identified with a person’s as required medicine (PRN). The PRN medication was not listed on the MAR chart which meant staff were unsure when to administer this medication although PRN protocols were in place.
● A person had been prescribed medication to treat high blood pressure. The MAR chart indicated the person had not taken the medicine for 18 days. Staff had previously recorded the medicine was not available. This had not been reviewed or followed up with a GP. This meant we could not be sure people had been supported to take their medicines as prescribed.
● Another person was prescribed pain relief cream as PRN and there were no instructions for staff on how to apply this cream.
● Not all staff had completed medication competency assessments before supporting people with medication. This meant people could not be assured that staff were competent to administer their medicines safely.
● Medication audit’s were not being completed regularly. This meant the registered manager was not able to identify errors and take prompt action to ensure people received their medicines safely.
Staff support: induction, training, skills and experience
● Staff told us they were supported with a 2 day induction when they first started working. However, most
staff told us they did not feel the induction prepared them for their role. Certificates of completed inductions were kept on staff files but induction booklets had not been signed off by the registered manager.
● Staff did not receive regular support in the form of a supervision or spot checks. The latter enables the registered manager to observe the member of staff as they go about their duties and check they are meeting the organisation’s standards and expectations. This meant there were no effective arrangements in place to monitor staffs’ practice, performance and professional practice. During the inspection the care manager had scheduled supervision’s for all staff.
● Although there was no impact for people using the service, staff training records showed not all staff employed at the service had received all mandatory or refresher training. Not all staff had up to date safeguarding, dementia awareness, epilepsy awareness and moving and handling training including the registered manager and care manager.
Suitable arrangements were not in place to ensure all staff employed received appropriate training, a robust induction or regular supervision. This was a breach of Regulation 18 [Staffing] of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014.
Ensuring people are well treated and supported; respecting equality and diversity
● Staff were focused and attentive to people’s emotions and support needs. A relative told us, “My [relative] really likes the carers. They are lovely people, and I am very grateful we have them.”
● Staff were able to tell us about people’s preferences and how they liked to be supported. A member of staff told us, ”I enjoy talking to people and understanding what they like or dislike. I love my work because of the people I support.”
● Feedback from relatives and people were mostly positive about how caring staff were. A relative told us, ”Yes definitely, can’t praise them enough.” However, one person told us, “Yes, they are kind and caring apart from if they get cross and frustrated.”
Supporting people to express their views and be involved in making decisions about their care
● Most people and their relative’s spoke positively about how staff communicated with them and supported
the person to make decisions. A relative told us, ”Staff always keep [relative] informed and include them in all decisions.” However, one relative told us, “A lot of the staff can’t speak English which is a barrier to [relative] and this makes it very difficult for us.”
● The registered manager sought consent from people to work closely with relative’s to ensure they were involved in decision making. A relative told us, ”We have regular contact and constant feedback given to us. I get a regular report and I am happy with the amount of support provided.”
End of life care and support
● People’s support plans did not include any information relating to people’s end of life wishes.
● Not all staff had completed end of life training. The registered manager had identified this and training had been arranged.
We recommend the provider seek and implement best practice guidance and training for staff on end of life care to ensure support plans are consistent, person-centred and respectful of people’s wishes about end of life care.
Improving care quality in response to complaints or concerns
● Most people told us when they raised concerns staff addressed issues compassionately. However, one
person told us, “Lots of complaints, I feel like they hear me, but they don’t listen, they don’t do anything, had conversations with the manager so many times, [manager] doesn’t listen.”
● Some staff felt unable to express concerns. A staff member told us, “I just get on with my work. I don’t make any complaints even if I wanted to as I just don’t think the management are very approachable and would listen.”
● There was a complaints policy that people, relatives and staff could refer to.
We recommend the service seek and implement best practice in ensuring people are appropriately updated
and supported during the complaints process.
Planning personalised care to ensure people have choice and control and to meet their needs and preferences
● People’s care plans contained information about their needs, including essential information relating to health, communication, likes and dislikes.
● Care records listed what ‘Good days’ and ‘Bad days’ could look like for the person. This enabled staff to provide the right level of support to ensure the person had choice and control and that their needs were met.
● People were supported by a team who knew them well and knew how they like to be supported. A person told us, “I get regular carers. I’m quite happy with the service I get. I’m not a complainer. I’m grateful for people who do the job, angels in disguise.”
Promoting a positive culture that is person-centred, open, inclusive and empowering, which achieves good outcomes for people; Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements
● The quality assurance and governance arrangements in place were not always effective in identifying shortfalls in the service. Specific information relating to the improvements required is cited within this report and demonstrated the arrangements for identifying and managing the above were not robust and required improvement.
●For example, no system was in place to make sure staff’s recruitment files, induction, training and supervision data were audited to ensure these were in line with regulatory requirements. No system was in place to audit people’s care plans, risk assessments, daily care records and evidence of medication being administered.
● The registered manager did not complete regular audits. This meant effective auditing arrangements were not in place to assess, monitor and improve the quality and safety of the service provided and lessons learned.
● Some staff were positive about working at the service and promoting good outcomes for people. Staff told us, ”The field care supervisor is very supportive. I like my job and I enjoy supporting people.” However, some staff told us, ”I don’t feel the service is managed well. We don’t often get the support we need, and the management are not very approachable.”
We found no evidence that people had been harmed, however we could not be assured the provider’s governance arrangements were robust and effectively managed. This placed people at risk of harm. This was a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
These guys looked after me for about 4 weeks and
It would be nice if they could take the human waste and masks with them when they leave our tower block, instead the carers throw it in our communal bins, nappies bags masks all sorts of medical waste every where, why do they not take it for incineration ,it's disgusting and wrong