Archived: Midas Care

Updated 25 December 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 checked whether the provider was 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 announced inspection took place between 25 October 2018 and 5 November 2018. This inspection was carried out by an inspection manager, two inspectors and an expert 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. Their area of expertise was caring for older people and people living with dementia.

We gave the service five days’ notice of the inspection because some of the people using it could not consent to a home visit from an inspector, which meant that we had to arrange for a ‘best interests’ decision about this. We also gained people's and relatives' consent for us to call them by telephone.

Before the inspection the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least annually. This provides us with information about the service, what the service does well and improvements they plan to make. We used this information to help us with the planning of this inspection. We also looked at other information we held about the service. This included information from responses to our survey questionnaire, as well as notifications the provider sent to us. A notification is information about important events which the provider is required to send to us by law such as incidents or allegations of harm.

Prior to our inspection we contacted the local safeguarding authority and commissioners of the service to ask them about their views of the service. These organisations’ views helped us to plan our inspection.

On the 25 and 30 October we spoke with a total of nine people who used the service. Between the 25 and 30 October 2018 we spoke with ten relatives of people who were not able to speak with us. On 31 October 2018 we visited the provider's office and we spoke with the registered manager, the clinical lead, the field care manager, the live-in care manager, two field care supervisors and three care staff. On 1 November 2018 we spoke with a further three care staff. On 2 and 5 November 2018 we shadowed care staff during their care visits and spoke with a further eight people and six care staff. On 6 November 2018 we also spoke with a visiting community nurse.

We looked at care records for 14 people using the service and their medicines' administration records. We also looked at three staff files, staff training and supervision planning records and other records relating to the management of the service. These included records associated with audit and quality assurance, accidents and incidents, compliments and complaints.

Updated 25 December 2018

This announced inspection took place between the 25 October and 5 November 2018.

Midas Care is a domiciliary care service which runs from an office based on the outskirts of Waterbeach. The service provided personal care to people. Not everyone using Midas Care received a regulated activity; Care Quality Commission (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 our last inspection of Midas Care, between 24 and 29 January 2018 we rated the service Requires Improvement. Improvements were needed to support people safely with their prescribed medicines. Incidents where people had not been safeguarded were not acted on and investigations had not always been undertaken. The provider's policy for complaints was not followed and the providers governance systems were not effective enough in identifying and driving the necessary improvements.

We asked the provider to complete an action plan to show what they would do, and by when, to improve the key question is the service safe, is the service effective, is the service caring, is the service responsive and is the service well-led to at least good. They sent us an action plan and told us they would make these improvements by 31 March 2018.

We carried out this inspection to see if the registered provider had acted in line with their action plan. We found the service had made the necessary improvements under the questions is the service effective, caring, and responsive which are now rated as 'Good'. However, further improvement was still needed for the questions, is the service safe? and is the service well-led? The service, therefore remains rated as 'Requires Improvement'. At the time of our inspection there were 201 people using the service.

A registered manager was 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 registered manager was new in post at the time of our last inspection. Since that inspection, and with the support of the new director of operations, they had made some significant changes to the way the service was run. The provider’s governance system and processes had improved. However. further work was needed to ensure better monitoring of improvement plans, with robust timescales and ensure actions are embedded in practice, and reviewed. This will help to drive continual improvement and give good outcomes for people.

Further work was required to ensure risks to people’s health, safety and welfare are identified and managed safely, with sufficiently detailed care planning arrangements to guide staff on how to minimise risk and meet people’s needs effectively.

Staff were recruited safely and improvements had been made to ensure there were enough suitably trained and supported staff to meet people’s needs. Medicines were administered and managed safely. Systems were in place to support good hygiene and infection prevention standards.

People’s decisions about their care were respected. Staff effectively supported people with their food and drink with input from healthcare professionals.

Staff were kind and caring, and sensitive to their needs. They promoted people’s independence, dignity and they respected people’s privacy. People were involved in their care.

Management worked with other professionals to ensure people’s needs were met. Management responded promptly to complaints and comments and they were resolved to the person’s satisfaction. Areas for learning from incidents, accidents and complaints were actioned and completed.