Background to this inspection
Updated
27 February 2018
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 carried out on 13 & 18 December 2017 by one inspector and 2 February 2018 by another inspector. The provider was given 24 hours’ notice because the location provides a domiciliary care service so we needed to be sure that someone would be in.
An expert-by-experience in domiciliary care services spoke with people who used the service and their relatives to gain their views over the telephone. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, the registered provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service. We also checked information that we held about the service and the service provider. We looked at any notifications received and reviewed any other information held about the service prior to our visit.
During the inspection we spoke with two people who used the service over the telephone. As some people using the service found it difficult to speak to us on the telephone, we spoke with five people’s relatives. We also spoke with the registered manager and the service director and two support staff.
We visited three people separately in their homes with their permission. We looked at care records for four people who used the service. Records reviewed included: staff rotas, policies and procedures, three staff files covering recruitment and training records, medicine administration records (MAR), and complaints.
Updated
27 February 2018
This inspection took place on the 13 & 18 December 2017 & 2 February 2018 and was announced.
At the last inspection of this service on 2 November 2016 we found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medication was not well managed, requirements of the Mental Capacity Act were not always followed, records were not always accurate, staff were not always receiving the support they needed and the quality assurance system in place was not effective. Following that inspection, we asked the provider to complete an action plan to show what they would do and by when to meet the requirements of the law. At this inspection we found the provider had followed their action plan and they were now meeting the requirements of the law.
This service is a domiciliary care agency. It provides a service to older adults, and to younger adults who have a learning and/ or a physical disability in their own homes. Not everyone using MASS receives 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 18 people were receiving personal care.
This service provides care and support 24 hours a day to four people living in two ‘supported living’ settings so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
MASS has 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.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
We found that a safe service was provided by a staff team who were appropriately recruited, trained and supported. Established systems were in place for preventing harm and abuse. Robust arrangements had been made to protect against risks, maintain health and wellbeing, and give medicines safely.
People received effective, personalised care that was thoroughly planned and had been adapted to meet their needs. They directed and agreed to their care and the principles of mental capacity law were applied in upholding their rights.
Staff were supportive, caring and provided dignified care. They understood individual’s preferences and supported their lifestyle and social interests. People were supported to express their views and make choices about their care.
The service had an open, inclusive culture and was well managed. Feedback was sought and there had been no complaints. The governance of the service ensured regular monitoring of standards and the quality of care provided. Where shortfalls were identified action had been taken to make improvements.