Date of assessment 1 August to 13 August 2025. Caremark Hinckley Bosworth Blaby Leicester is a home care provider that provides support to people of all ages living dementia, learning disabilities, physical disabilities and mental health conditions. At the time of this assessment there were 77 people using the service, 51 of whom received regulated care. This assessment was completed in part due to information of concern we had obtained in relation to the provision of care staff. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The provider mostly had a good learning culture based on openness and honesty, but some issues went unidentified for prolonged periods. People were protected and kept safe. Staff understood and managed risks. People received required care, however, scheduled care visits did not always meet people’s preferences and staff were not always provided with travel time. Equipment and technology supported the delivery of safe care. Care staff received training to meet people’s care needs. Medicines were mostly managed safely. People were involved in assessments of their needs. People’s nutritional and hydration needs were mostly met. Staff worked with other agencies involved in people’s care for the best outcomes. People were treated with kindness and respect. Staff protected their privacy and dignity. They treated them as individuals and mostly supported their preferences. Staff responded to people in a timely way. The provider supported staff wellbeing. The provider made sure people were at the centre of their care and treatment. People knew how to raise concerns and give feedback. People mostly received fair and equal care and treatment. People were supported to plan for their future. The provider mostly fostered a positive culture where people felt they could speak up and their voice would be heard. Leaders had the skills, knowledge and experience to lead effectively, though needed to ensure their quality assurance processes identified and acted on shortfalls.
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Caremark Hinckley Bosworth & Blaby improved from Requires Improvement to Good following a follow-up inspection on 27 July 2023, having remedied previous breaches of Regulations 12, 17 and 19. The service demonstrated safe care delivery, robust governance improvements and a positive person-centred culture, with only minor areas identified for further development around quality assurance analysis and weekend staffing.
Concerns (2)
minorGovernance — “We identified, the analysis was not fully reflective of the feedback received and gave limited useful information to support the service to develop.”
minorStaffing levels — “A small number of staff felt support, communication, and staffing at weekends could be improved upon.”
Strengths
· Risks to people's health and well-being had been assessed and planned for with detailed staff guidance, and no missed calls with minimal late calls.
· Staff recruited safely with DBS checks and references completed before starting work.
· Medicines managed and administered safely with staff training and competency assessments in place.
· Accidents and incidents recorded, acted upon and analysed for learning opportunities.
· Infection prevention and control best practice followed, including PPE spot checks by management.
Focused inspection found breaches of Regulations 12, 17 and 19 with unsafe medicines management, late/cut-short calls, poor PPE compliance, weak recruitment and ineffective governance, leading to a downgrade from Good to Requires Improvement. A warning notice was issued for governance failings, although people reported feeling safe and staff understood safeguarding.
Concerns (12)
criticalMedication management — “Where MAR charts were in place, they were not always up to date with prescribed medicines for each person and did not detail the correct level of support people needed.”
criticalMissed or late visits — “Of these 27, 13 reported late calls, issues with staffing or not knowing which staff member would attend. Staff told us morning calls can run up to one o'clock in the afternoon”
criticalCare planning — “Care plans did not always reflect people's current needs and there was a lack of clear guidance for staff on how to manage people's conditions safely.”
criticalInfection control — “We were not assured staff were using personal protective equipment (PPE) effectively and safely in accordance with government guidance.”
criticalGovernance — “the quality monitoring system did not effectively identify and address people's concerns regarding calls not happening at the agreed times and lasting the full duration.”
criticalOther — “Staff were not always recruited safely... not all had two references or full employment histories.”
moderateStaffing levels — “The provider did not effectively deploy staff to meet the needs of the people they supported.”
moderateRecord keeping — “Oversight of records relating to the care and treatment of people using the service was not sufficient. The provider's own checks had not identified records were not all up to date”
moderateSupervision / appraisal — “Staff did not receive annual reviews, regular supervision, or regular spot checks.”
moderateLeadership — “We received mixed views from staff about the leadership of the service... 'The support for the staff isn't good.'”
moderatePerson-centred care — “People did not always receive person centred care... 'I never know when they are coming,' and another said, 'They don't let me know if they are running late, they just turn up.'”
moderateCommunication with families — “There was a lack of systems and processes in place to ensure people were reliably informed about changes to their care workers.”
Strengths
· People and their relatives told us they felt safe when receiving care.
· Staff understood abuse and had received safeguarding training, and felt confident reporting concerns.
· Safeguarding issues had been reported to the local safeguarding team and notifications submitted to CQC.
· All staff had undertaken a satisfactory DBS check.
· The registered manager had a good understanding of the duty of candour and had an appropriate policy in place.
Quality-Statement breakdown (9)
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongNot rated
safe: Staffing and recruitmentNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Continuous learning and improving care; Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated