Caremark Basingstoke and Deane

The service is a domiciliary care agency which provides personal care to people living in their own homes. It provides a service to older and younger adults, people living with dementia, autistic spectrum disorder, physical disability, mental health needs and sensory impairment. The service enables people living in Basingstoke and the surrounding areas to maintain their independence at home. At the time of our inspection there were 25 people using the service, who had a range of health and social care needs which were met by 14 staff.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were kept safe from harm by staff who knew what to do to maintain their safety and protect them from abuse.

Staff identified risks to people's safety with them and how these could be managed safely, whilst promoting their independence. Staff understood the risks to people and delivered safe care in accordance with their support plans.

Staff underwent appropriate training to equip them to deal with different types of emergency. Incidents and accidents were recorded and investigated. Action was taken to implement identified learning to reduce the risk of further incidents and accidents.

The provider applied thorough recruitment procedures to ensure staff were suitable to support people made vulnerable by circumstances living in their own home. The registered manager completed rotas which ensured that enough suitably qualified staff, with the right skills mix, were deployed to provide care and support to meet people's needs safely.

Staff had completed the required training to manage people's prescribed medicines safely and had their competency to do so regularly assessed by the registered manager.

Staff supported people to maintain high standards of cleanliness and hygiene in their homes, and to safely manage the control and prevention of infection, particularly in relation to the safe preparation of food.

The provider had enabled staff to develop and maintain the necessary skills and knowledge to meet people's needs effectively. The management team effectively operated a system of spot checks, supervision,

appraisal and monthly meetings which supported staff to deliver care based on best practice.

People were protected from the risks of malnutrition and supported to eat a healthy diet of their choice.

Staff supported people to maintain their health and ensured they were referred promptly to appropriate healthcare professionals whenever their needs changed.

The registered manager and staff clearly understood their responsibilities in relation to the Mental Capacity Act 2005. People were involved in making every day decisions and choices about how they wanted to live their lives. Staff supported people in the least restrictive way possible.

People's independence was promoted by staff who encouraged them to do as much for themselves as possible. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights.

Staff understood people's different communication needs and ensured they followed the guidance provided in people's care plans to enable them to communicate their views. The service was responsive and involved people in developing their support plans which were detailed and personalised to ensure their individual preferences were known.

The registered manager sought feedback in quality assurance visits, satisfaction surveys and telephone calls. The registered manager ensured this feedback was acted upon through staff meetings and supervisions.

Complaints and concerns formed part of the provider's quality auditing processes so that on-going learning and development of the service was achieved. People and relatives felt that staff listened to their concerns, which were quickly addressed.

People were offered regular opportunities to discuss their advanced wishes in relation to end of life care. When people were nearing the end of their life they experienced kind and compassionate care.

The registered manager was highly visible and regularly went to see people if they were upset or had raised concerns. The registered manager provided clear and direct leadership to staff who had a good understanding of their roles and responsibilities.

Quality assurance systems were in place to monitor the quality of service being delivered. The registered manager had completed a risk assessment in relation to the potential impact of key staff absence on these processes.

The registered manager worked effectively in partnership with other agencies to support care provision and service development including community nursing specialists.

People's and staff records were stored securely, protecting their confidential information from unauthorised persons.

The five questions we ask about services and what we found