Caremark (Kingston) was rated Good across all five key questions at this October 2023 inspection, maintaining the rating awarded in 2018 and improving Effective from Requires Improvement. The service demonstrated safe, person-centred care with well-trained, compassionate staff, robust governance, and effective partnership working with healthcare professionals.
Strengths
· Staff were compassionate, well-trained, and consistently described as professional and kind by people and relatives.
· Risks were thoroughly assessed, monitored, and regularly reviewed with care plans updated as needs changed.
· Robust recruitment process including scenario-based interviews, DBS checks, references, and a 3-month probationary period.
· Medicines records were regularly audited, fully completed, and up to date with staff trained and refreshed in administration.
· Open and inclusive culture with clear leadership, approachable management, and strong staff retention (one staff member noted 12 years of service).
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersGood
well-led: Continuous learning and improving careGood
Caremark (Kingston) was rated overall Good at its July 2018 inspection, with Requires Improvement in Effective due to gaps in ongoing staff training — particularly around MCA, safeguarding and infection control — with some staff unable to recall or explain the MCA despite being trained during induction. All other key questions were rated Good, with notable strengths in caring, responsive practice and strong leadership.
Concerns (3)
moderateStaff training: “staff were only provided with regular training in relation to first aid, moving and handling and food hygiene... staff were trained for this during the induction and that there weren't any training courses in place to update staff”
moderateStaff competency: “two people told us they felt that staff were lacking knowledge about their medical condition. One person said their staff member 'doesn't seem to understand totally'”
moderateConsent / capacity: “All staff that we talked to told us they could not remember attending training regarding the Mental Capacity Act 2005 (MCA). Consequently, they couldn't tell us what the MCA was”
Strengths
· People and relatives consistently praised staff as kind, caring and reliable, with staff arriving on time and staying for the full visit duration.
· Robust safeguarding processes and risk assessments were in place, including individual fire risk assessments and collaboration with healthcare professionals.
· Strong recruitment procedures including DBS checks, references and interviews ensured staff suitability.
· Effective complaints handling with regular feedback questionnaires and prompt management responses.
· Clear leadership structure with open-door policy, regular supervisions, appraisals, and quality assurance audits.
Quality-Statement breakdown (19)
safe: Safeguarding systems and incident/accident recordingGood
safe: Risk assessments including fire safety and manual handlingGood
safe: Staff recruitment and pre-employment checksGood
safe: Medicines administration and supportGood
effective: Ongoing staff training and knowledge updatesRequires improvement
effective: Staff supervision and appraisalGood
effective: Manual handling and mobility supportGood
effective: Nutrition and meal preparation supportGood
Caremark (Kingston) received a Good rating across all five key questions at its January 2016 announced inspection, demonstrating safe recruitment, effective staff training, person-centred care, and a well-functioning governance structure. Minor gaps were noted in some staff's understanding of the Mental Capacity Act and the previous informality of supervision arrangements, both of which the manager had already taken steps to address.
Concerns (2)
minorConsent / capacity: “some of the caring staff we spoke with did not fully understand the principles of the MCA and how it could affect the people they supported.”
minorSupervision / appraisal: “Staff told us they had not always received formal supervision sessions in the past with their supervisor”
Strengths
· 94% of people felt safe from abuse or harm from their care staff, with strong safeguarding knowledge among staff.
· Provider had an in-house trainer allowing tailored training with minimal disruption; staff completed the Care Certificate within 12 weeks.
· Consistent care staff assigned to individuals, fostering continuity and person-centred relationships described as 'part of the family'.
· Medicines delivered in pre-filled blister packs and MAR sheets audited at the office to minimise administration errors.
· Provider developed a 24-hour live-in care service and palliative care service with additional hospice training for staff.