Caremark Tunbridge Wells, Tonbridge and Malling

We identified inconsistent performance across key areas, with improvements underway but not yet fully embedded. This meant people did not always experience safe, coordinated and responsive care.This provider has had a new management team in place since the last inspection and steps have been taken to address the shortfalls found at this assessment. However, these have not been embedded.

The provider had recognised historical weaknesses in care planning, review systems, governance and staffing consistency. There was evidence leaders had taken action to address these concerns through recruitment, review programmes, training, audit activity and increased management oversight. However, these changes were recent, and the provider could not yet consistently demonstrate that improvements had become embedded in day-to-day practice or had resulted in sustained better outcomes for people.

People were not always protected from avoidable harm. Risk management systems, communication arrangements and care planning processes were not consistently reliable. People and relatives described missed or delayed visits, poor continuity of staff, inconsistent communication from the office and concerns relating to medicines and care delivery. Although some staff demonstrated good risk awareness and prompt escalation of health concerns, organisational systems did not always provide assurance that risks were identified, recorded and responded to consistently.

Care was not always effective because assessments, risk assessments and care plans were not consistently detailed, current or sufficiently person-centred. Staff generally described receiving induction, mandatory training and support from managers. However, variability in staff experience and the quality of information available to them meant people did not always receive consistent care that reflected their full needs.

There were clear strengths in the caring culture of the service. People often spoke positively about individual care workers, describing them as kind, respectful and compassionate. Staff described the importance of reassurance, dignity and a human approach to care in people’s own homes. However, these strengths were undermined at times by inconsistent service delivery, particularly when people were supported by unfamiliar staff or where the providers systems did not respond effectively to concerns.

The service was not always responsive. People and relatives did not always feel listened to when concerns were raised and did not always receive clear information about their care. Reviews and future planning were not consistently completed, and care was not always delivered in a way that reflected people’s individual routines, risks and changing needs. Leadership was visible and had a clear intention to improve, but governance systems were not yet robust enough to consistently assure the quality, safety and sustainability of the service.