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Inspection Summary


Overall summary & rating

Good

Updated 14 December 2016

.This announced inspection took place on 9 November 2016. We told the provider two days before our visit that we would be coming, as we wanted to make sure the registered manager would be available. At the last inspection, on 4 February 2014, the service was meeting all the legal requirements that we inspected.

Mackley Home Care Limited is a domiciliary care service providing personal care and support for people living in their own homes in the Bromley area. At the time of this inspection there were approximately 25 people using the service.

There was a registered manager in post; 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. At the time of this inspection the operations manager was in the process of applying to job share with the current registered manager.

People received their medicines when they should and staff had received training on the safe administration of medicines. However we found some aspects of the medicines policies and procedures required updating to include current guidance for staff. We have therefore made a recommendation about some aspects of the safe management of medicines. We will check the progress on this at our next inspection.

People told us they felt safe from harm and well cared for by the service. Care workers had received training on safeguarding adults, so they knew the signs of possible abuse. There were suitable arrangements to deal with a range of emergencies if needed. Possible risks to people were identified and guidance was in place to reduce risk.

People said their care workers were caring and kind, and, that some of them went out of their way to support them. People had the same care worker or small group of care workers, who they said knew their needs and preferences well. People said they were involved in decisions about their care and they were treated with respect and dignity at all times.

People commented that their care workers were reliable and were rarely late. There were enough care workers and office staff to meet people’s needs and the provider followed safe recruitment policies. Staff received suitable training and support to carry out their roles. People were asked for their consent before care was provided and staff were aware of their responsibilities under the Mental Capacity Act (2005). People’s dietary needs were met, where they needed support to manage this. The service worked with health professionals, when necessary, to ensure people’s changing health needs were addressed.

People had an assessed and written plan of care available in their homes; these were up to date and people told us they reflected their needs and individuality. People said they were involved in reviewing the plans and that any changes were updated in the care plan. There was a complaints procedure and people knew how to raise a complaint.

People and their relatives told us the service was efficient and provided consistently good care. It was a small service with a stable management team, who, were involved in direct care delivery and therefore had frequent contact with people. They were therefore familiar with people’s needs and able to directly monitor the quality of the service. There were robust communication systems about people’s needs and staff felt well supported in their roles. People told us they were asked for their views about the service and felt listened to and that the service considered any improvements that could be made.

Inspection areas

Safe

Requires improvement

Updated 14 December 2016

The service was safe.

There were systems in place to safely manage the administration of medicines, where this was required. However best practice guidance was not always available and we have made a recommendation in relation to the safe management of medicines.

People told us they felt safe using the service. Staff received appropriate training about safeguarding people from abuse and knew how to raise an alert.

Risks to people who used the service were identified and addressed to minimise the likelihood of them occurring. Procedures were in place to deal with any emergencies should they arise.

There were adequate numbers of staff employed and safe recruitment processes were in place.

Effective

Good

Updated 14 December 2016

The service was effective.

People told us their consent was sought before they received care. Staff understood the requirements of the Mental Capacity Act (2005) Code of Practice and acted in line with this.

Care workers received training in line with the provider’s guidance. They told us they were supported in their roles. There was a suitable induction for new staff which included a period of shadowing.

Where needed people were supported with their nutritional needs. People’s health needs were monitored and they were referred to relevant health professionals, when this was appropriate.

Caring

Good

Updated 14 December 2016

The service was caring.

People told us the care workers were kind, and considerate and knew them well.

People and their relatives said that they were involved in planning for their care, and their preferences and wishes were respected.

Responsive

Good

Updated 14 December 2016

The service was responsive.

People had a plan of their care and support that addressed their individual needs. People said they received the right kind of care and support to meet their needs and care workers were attentive to any required changes.

People and their relatives told us they felt their views were listened to and issues were addressed. They knew how to make a complaint but said they had not needed to do so.

Well-led

Good

Updated 14 December 2016

The service was well led.

People told us they felt their views were sought about their care and the service was efficient and well managed. There was an effective communication system to ensure staff were aware of any changes.

Staff told us the service was well organised and that they felt supported.

The managers and office staff were directly involved in the delivery of care and told us they found this an effective way to monitor the quality of the service and act on ways to make improvements. Other checks were completed to ensure people got their care as planned.