Archived: Mears Homecare Limited DCA (Sheffield)

Mears Homecare Limited DCA (Sheffield) is a domiciliary care service. The agency office is based in the S4 area of Sheffield. They are registered to provide personal care to people in their own homes throughout the city of Sheffield. At the time of our inspection the service was providing personal care for 436 people. There were approximately 123 staff employed by the agency.

Mears Homecare Limited DCA (Sheffield) was known under the name of Care UK DCA (Sheffield) until August 2015 when the provider changed the agency name.

The service was last inspected on 6, 9 and 10 March 2015 and was found to be in breach of five of the regulations we inspected at that time. People were not protected against the risks associated with medicines because some people were not supported safely with their medication. People did not always receive person centred care and treatment that was appropriate and met their identified needs. People employed by the service did not receive appropriate supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. Adequate systems were not in place to ensure an accurate and contemporaneous record in respect of each service user was maintained. Adequate systems were not in operation to assess, monitor and improve the quality and safety of the services provided in the carrying on of the regulated activity. The provider sent a report of the actions they would take to meet the legal requirements of these regulations, which stated they would be compliant by 31 October 2015. We checked whether these regulations had been met as part of this comprehensive inspection.

It is a condition of registration with the Care Quality Commission that the service has a registered 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 manager had been in post since January 2016 and had applied to register with us.

Significant changes to the staffing at Mears Homecare Limited DCA (Sheffield) had occurred since our last inspection. The previous registered manager and area manager had left the agency and some care workers had also left. In addition, high levels of staff sickness had impacted on the running of the agency. The provider had put additional staff and systems in place to support the on-going improvement of the service.

All of the staff and most people spoken with reported improvements to the agency in recent weeks.

People spoken with said they had regular care workers that they knew well. People told us their regular care workers were kind, caring and considerate. They told us they felt safe with their regular care workers. When their regular care workers were not available people told us the service was not as reliable.

The provider did not have adequate systems to ensure the safe handling, administration and recording of medicines to keep people safe.

Staff recruitment procedures were thorough and ensured people’s safety was promoted. The provider had undertaken all the checks required to make sure people who were employed at Mears Homecare Limited DCA (Sheffield) were suitable to be employed.

Whilst the provider used agency staff to cover visits until permanent care workers were recruited, people did not have their needs met by sufficient numbers of suitably deployed staff which resulted in some missed visits.

Some staff did not receive regular supervisions or appraisal.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role.

People’s care plans contained information on the support needed and risks to the person so that important information was provided to ensure people’s identified needs could be met.

Most people felt staff were caring and respected their privacy and dignity. However there were examples where this was not the case.

Some people felt complaining did not improve the service they received as any concerns they raised weren’t responded to or acted upon. People told us they did not always get a response when they telephoned the agency office.

There were some systems in place to assess and monitor the quality of service provided. The provider had an improvement and action plan that showed audits had taken place to measure improvement and identify further actions needed to continue improvements. The provider’s action plan identified gaps in some audits.

We found seven breaches in five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in; Regulation 10: Dignity and respect, Regulation 12: Safe care and treatment, Regulation 16: Receiving and acting on complaints, Regulation 17: Good governance and Regulation 18: Staffing.

You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

During our inspection visit we spoke with the head of quality, the registered manager and the care manager about the running and management of the agency. We spoke with a care coordinator and a field care supervisor about their role. We spoke with 6 care workers over the telephone about working for Care UK Homecare.

We telephoned 53 people supported by Care UK and spoke with 37 people using the service, or their relative about the support provided. In the main they told us they were happy with the agency. Their comments included, 'Staff are excellent,' 'They are reliable, lovely people' and 'I would recommend them.'

We found that before people received any care and support they were asked for their opinion and agreement to ensure staff acted in accordance with their wishes.

We found people's care and support needs were assessed and each person had a written care plan that set out their identified needs and the actions required of staff to meet these.

We found policies were in place to ensure medicines were handled safely.

The provider had a satisfactory recruitment and selection procedure in place to ensure staff were appropriately employed.

The provider had an effective complaints system available.

We spoke with Sheffield Local Authority, contracting and commissioning and they told us that they had not identified any concerns at the service.

We spoke with four people who received a service from this agency over the telephone. Everyone spoke positively about their care workers and felt that they fully supported their care needs. Without exception, people said that all their care workers spoke with them in a calm and respectful way. All four people we spoke with told us that their care was personalised to their needs. In all cases, people were happy with their care workers and said that the care workers adapted very well when changes were made to the care they required.

We spoke with three relatives of people that received care. They confirmed they had been involved in discussing and reviewing the care of their loved one with a supervisor from the agency.

People and their relatives felt that staff were well trained and understood their needs. One person told us, "my regular care workers do everything just as I like it."

People told us that they felt safe, and if they had concerns they would speak with somebody from the office.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

We spoke with Sheffield Local Authority, contracting and commissioning and they told us that they had not identified any concerns at the home.