Archived: Mears Help to Live at Home Wiltshire

Updated 12 February 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was announced and took place on 9 and 18 December. The inspection was undertaken by one inspector and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We spoke with 32 people who used the service, 10 relatives and 9 staff on the telephone. We spoke with 8 staff in the office, including care co-ordinators, service managers, the registered manager and a senior manager. We looked at people’s paper records and documentation in relation to the management of the agency. This included staff supervision, training and recruitment records, quality auditing processes and policies and procedures.

Updated 12 February 2016

This inspection took place on 9 and 18 December 2015. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a domiciliary care service. We wanted to make sure the manager, or someone who could act on their behalf would be available to support our inspection.

Mears Help to Live at Home Wiltshire is a large domiciliary care agency which provides care and support to people in their own homes on a short and long term basis. The agency manages the local authority’s Help to Live at Home contract.

The agency had a register manager in place. 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 present throughout the inspection.

During an inspection in June 2014, significant concerns were identified in relation to people’s care. We issued a warning notice and four compliance actions to ensure the provider made improvements. We undertook an inspection in August 2014, to ensure the shortfalls had been addressed. However, further widespread shortfalls in care provision, such as missed calls and inadequate care planning were noted. The warning notice, which we had issued in June 2014, had not been complied with. Due to the risk of significant harm to people’s safety, we issued a Notice of Decision, which restricted the provider from accepting any new care packages unless with our prior agreement. Another inspection was undertaken in December 2014, to review the restriction and to ensure people’s safety was assured. Improvements had been made but these needed to be further maintained and embedded within the service. We identified additional shortfalls in relation to the safe administration of medicines, consent and risk management. The provider sent us a detailed action plan to show how they would make improvements.

At this inspection, which took place on 9 and 18 December 2015, all shortfalls had been addressed. Improvements had been made to each area of the service. The registered manager told us they now thought Mears Help to Live at Home Wiltshire provided a safe, effective and responsive service. People and staff confirmed this. There were many positive comments about recent improvements and how the agency had “turned the service around”.

People told us they felt safe and were happy with the service they received. There were no longer any concerns about missed visits. People said they were generally supported by a small team of staff who they were getting to know well. This improved consistency of people’s care. Additional staff had been recruited. This meant staff had a manageable amount of visits and did not feel rushed, when travelling from one person to another. People told us the timing of their visits had improved and there was greater understanding about the agency’s “outcome based” approach. This had lessened frustration about inconsistent lengths of people’s visits. People told us they felt listened to and were encouraged to give their views about the service. Whilst people were aware of how to make a complaint, they did not fell they needed to, as they were now happy with the service they received.

Potential risks to people’s safety had been identified and properly addressed. People had been visited to discuss the support they required. People had a plan of their care which was detailed and well written. People told us their care was regularly reviewed to ensure it remained appropriate.

Improvements had been made to the management of people’s medicines. Medicines were now administered safely, in a person centred manner. Staff had undertaken recent training in the safe management of medicines and records had been improved upon.

There were positive comments about the staff and the registered manager. The registered manager provided clear leadership and had introduced systems, which were now embedded and working well. This included a range of audits to assess the safety and quality of the service. Staff told us they were well supported and had received updated training. All staff had been allocated to newly devised teams to aid communication and team building.