2 March 2023
During an inspection looking at part of 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.