This inspection took place on the 27 March and 11 April 2018 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. This service was previously inspected on 27 October 2015 and was rated as ‘good’ in all five ‘key question’ domains of ‘safe, effective, caring, responsive and well-led’.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to people with varying levels of need, including older people, younger adults, people living with dementia and mental health, eating disorders, substance misuse problems, learning disability, physical disability and sensory impairment.

There was a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission 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. The registered manager was also one of two registered providers for this service.

Caremark (Mid Sussex and Crawley) provides personal care services to people living in the Haywards Heath, Burgess Hill and Crawley areas. Companionship and domestic support can also be provided. Not everyone using this Caremark service received regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection, 147 people received a service from the agency.

This agency provided an extremely personalised and innovative service to people living in their own homes in the community. As well as the more traditional care at home service provided to people, the local social services department had funded a six month pilot for a new responsive model of care called ‘Patch Care’. This new model of care had been created and designed by the Caremark Franchise and taken to the local social services department to fund the pilot project. This service provided an innovative and exciting new model of care with a more tailored approach to care than most traditional care at home services. People and staff included within the new pilot enjoyed the benefits of a more flexible service that responded to individual needs at variable times when people really needed and wanted the support. People were actively engaged and involved in shaping the service provided by this agency and the new ‘Patch Care’ pilot involved people and aimed to tackle the issue of loneliness and social isolation for people.

The agency was engaged very proactively and positively with community organisations in support of people and their relatives living with Parkinson’s Disease. On World Parkinson’s Day the agency worked closely with local Parkinson’s Society representatives to organise a community event which was attended by over 25 people and their relatives, as well as staff and the management of the agency. We also attended this event and observed the positive benefits for people.

People were supported by a very caring staff and management team who demonstrated kindness and compassion towards people, their relatives and their colleagues alike. Staff were reported to have helped people to maintain their independence and also supported a person to regain their confidence to walk again with staff support, dedication and positive encouragement. There was a very evident person-centred culture throughout the agency with staff who demonstrated real passion and dedication towards people and towards each other. People and their relatives were without exception extremely positive and happy with the service they received an

The inspection took place on the 27 October 2015 and was announced. The provider was given 48 hour’s notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

Caremark (Mid Sussex and Crawley) is a domiciliary care service which provides personal care and support services for a range of people living in their own homes. These included older people, people living with dementia and people with a physical disability. At the time of our inspection 162 people were receiving a care service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

The experiences of people were positive. People told us they felt safe and staff were kind and the care they received was good. One person told us “Oh yes I feel safe, I look forward to seeing the staff”.

There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff at all times to meet people’s needs. When the provider employed new staff at the service they followed safe recruitment practices.

Assessments were undertaken to identify people’s support needs and care plans were developed outlining how these needs were to be met. We found that care plans were detailed which enabled staff to provide the individual care people needed. People told us they were involved in the care plans and were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access to health care services when needed.

The service considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

People were supported at mealtimes to access food and drink of their choice and were supported to undertake activities away from their home.

Staff had the skills and knowledge to meet people’s needs. Staff received regular training to ensure they had up to date information to undertake their roles and responsibilities.

There were clear lines of accountability. The service had good leadership and direction from the registered manager. Staff felt fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. For example staff were offered to undertake additional training and development courses to increase their understanding of needs of people using the service.

Feedback was sought by the registered manager via surveys which were sent to people and their relatives. Survey results were positive and any issues identified acted upon. People and relatives we spoke with were aware of how to make a complaint and felt they would have no problem raising any issues. The provider responded to complaints in a timely manner with details of any action taken.

The inspection began at 10.20 and ended at 15.10. We spoke on the telephone to two people who used the service and to five representatives (relatives) of people who used the service. We also spoke with the manager and seven members of staff. People and their representatives told us that they felt listened to and that the service responded well when they requested changes. “I made suggestions about the rota and they soon sorted it out” one relative told us. People took part in decisions about their care and treatment.

People told us that their care and support had been well managed. One person said "It’s going very well. Staff are very good.". Another said "Staff are excellent, they do a very good job.” People told us that carers were punctual, and supported them in the way they wished to be supported. We saw that care plans showed that needs and risk assessments were in place which enabled care workers to support individuals in a safe and appropriate way.

Care staff had received training and support which had helped them deliver care and treatment to people safely and to an appropriate standard.

People felt they could approach the service if they had any concerns or complaints. They told us that the service took positive action when issues were raised.

We did not speak to the people who use this agency however feedback from the Local Authority was positive. The records we looked at showed that people had had a full assessment of their needs prior to receiving a service from the agency and that they were involved with the planning of their care. Care records were detailed and individualised and people's specialist needs were being met.

We spoke on the telephone to two people who used the service and two representatives (relatives) of people who used the service. They told us that they felt listened to and were able to take part in decisions about their care and treatment. All were pleased with the care provided. People told us that care and support had been well managed. One person said “Care is going very well. I have a disability but they assist me with being independent.". Another person told us “Staff are very friendly, and the office staff are very organised".

There was evidence in the care plans that needs and risk assessments had been completed in detail, which enabled care workers to support individuals in a safe and appropriate way.

Records showed that there were robust recruitment procedures to make sure staff employed were fit to carry out their work. There was evidence in records and in talking to care staff that the training they received helped them deliver care and treatment to people safely and to an appropriate standard.

We found that the service had regularly assessed and managed risks relating to the health, welfare and safety of people receiving a service.