Charmes Care

Updated 13 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was conducted by 1 inspector and 1 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 2 March 2023 and ended on 15 March 2023. We visited the location’s office on 2 March 2023.

What we did before the inspection

We reviewed the information we had received about the service, including the previous inspection report and notifications. Notifications are information about specific important events the service is legally required to send to us. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager for Charmes Care, and 4 of the provider’s senior management team. We spoke with the director of the service, who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke to 3 external professionals who have had involvement with the service. We spoke to 6 staff members, 3 people who use the service and 8 relatives.

We reviewed a range of records, including 7 people's care records in detail, and 7 people's medicines records. Staff records were reviewed in relation to the care visits they completed. A variety of records relating to the management of the service, including audits, policies and procedures were also reviewed.

Updated 13 June 2023

About the service

Charmes Care is a domiciliary care agency which provides support and personal care to people living in their own home. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time our inspection visit commenced, 35 people were receiving a regulated activity from the service. When we completed our inspection activity, due to planned changes to the service this had reduced to 29 people.

People’s experience of using this service and what we found

People's care plans were up to date and contained person centred information. However, not all risk assessments for people contained sufficient information which would enable staff to understand how to mitigate the risk of harm. This placed people at risk of not receiving the appropriate care and treatment they required. We have made a recommendation about this in the report.

Staff had received training in safeguarding people, and they knew how to report any signs of abuse, or any accidents and incidents. However, we found safeguarding concerns were not always recognised by the management team or shared with CQC and the local authority as required.

Most people and relatives we spoke with, felt staff were kind and caring but were dissatisfied with the service they received. This was in relation to the time of day they received their visit, the length of the visit and communication with the management team.

Staff did not always feel supported in their role and felt they were not listened to if they raised concerns. Travel time was not always allocated and staff told us they were often rushed or unable to meet all of people’s needs within the time given. This impacted on the culture of the service.

Staff had completed training in the safe administration of medicines and had their competency assessed to do so safely. People were happy with how they were supported around their medicines. However, improvements were needed to medicine records to ensure staff had the information they needed to administer ‘as and when required medicines’, and there was sufficient time in between doses.

There were quality assurance systems in place based on a range of audits. However, we found these were not always effective. They had not identified all the concerns we identified during this inspection.

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 supported this practice.

People told us care staff were kind and caring and they felt safe with them. Staff respected people's right to privacy and dignity and promoted independence.

Staff felt they could contact the management team and they were informed of any important information or changes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 26 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This inspection was prompted by the previous rating of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Charmes Care on our website at www.cqc.org.uk.

Enforcement

We have identified breaches of regulation in relation to, safeguarding, staffing and governance at this inspection. We have made a recommendation about risk management.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.