Archived: Mears Care Limited - Middlesbrough

Updated 14 April 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 checked 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.

We inspected Mears Care Limited Middlesbrough on 22 and 23 December 2015. This was an announced inspection. We gave the registered provider short notice we would be visiting.

The inspection team consisted of one adult social care inspector one, expert by experience that had experience of domiciliary care. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience made telephone calls to people who used the service and relatives to find out their views on the care and service they received. The inspection team also consisted of one specialist professional advisor (SPA). A SPA is someone who has specialist knowledge about this type of care service.

Before the inspection we reviewed all the information we held about the service. The registered provider was not asked to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

At the time of our inspection visit there were 225 people who used the service.

During the inspection we spoke with 24 people who used the service or their family members / representatives. We also visited four people in their home. We spoke with the registered manager, one care coordinator and nine care staff. We contacted the local authority to find out their views of the service. We looked at seven people’s care records, including care planning documentation and medication records. We also looked at staff files, including staff recruitment and training records, records relating to the management of the service and a variety of policies and procedures developed and implemented by the registered provider.

Updated 14 April 2016

We inspected Mears Care Limited Middlesbrough on 22 and 23 December 2015. This was an announced inspection. We informed the registered provider at short notice we would be visiting to inspect. We did this because we wanted the registered manager to be present at the service on the day of the inspection to provide us with the information we needed.

The service is registered to provide personal care to people living in their own homes. The service can provide care and support to children, younger adults, older people, people living with dementia, people with learning disabilities or autistic spectrum disorder, people with mental health conditions, people with sensory impairments or physical disabilities and people who misuse drugs and alcohol.

The service had a registered manager. 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.

Systems to manage people’s medicines was not robust. The service was not effectively ensuring that staff had the correct information to administer the correct dose for people in the correct way. Each person’s individual circumstances in relation to medications were not assessed, the risks were not highlighted and therefore plans were not in place to mitigate those risks.

The service was not using the Mental Capacity Act (MCA) 2005 during assessment and care planning to evidence consent or best interest decisions being made on behalf of people.

Staff at the service worked with other healthcare professionals to support the people. Staff worked and communicated with social workers, occupational therapists, hospital staff as part of the assessment and on-going reviews. However the detail of people’s health conditions and how staff should manage them, particularly in relation to an emergency was not recorded in peoples care plans.

Staff told us that the registered manager was supportive. Most staff had received regular and recent supervision. Supervision is a process, usually a meeting, by which an organisation provide guidance and support to staff. Most staff had received an annual appraisal. The registered manager had a plan to ensure all of these were up to date in January 2016.

The majority of staff training were up to date. Staff told us they had received training which had provided them with the knowledge and skills to provide care and support. Outstanding training had been arranged for January 2016 to ensure that all staff were up to date.

Assessments were undertaken to identify people’s care and support needs. Care records reviewed contained information about the person's likes, dislikes and personal choices. There was evidence that people and their families were involved in the process.

There were enough staff employed to provide support and ensure that people’s needs were met. People told us staff were reliable and that the office communicated well with them when staff may be late to their call.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.

Prior to the commencement of the service staff from the service completed environmental risk assessments of the person’s home. Safety checks looked at the gas and electricity points, equipment to be used and general environment checking for clutter and falls risks. This meant that the registered provider took steps to ensure the safety of people and staff.

There were risk assessments in place for people who used the service. The risk assessments and care plans had been reviewed and updated on a regular basis. Risk assessments covered areas such as mobility and falls. This meant that staff had the written guidance they needed to help people to remain safe.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

People and relatives told us that staff treated people with dignity and respect. Staff were attentive, showed compassion, were patient and gave encouragement to people.

People were provided with their choice of food and drinks which helped to ensure that their nutritional needs were met.

The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take action to support them.

There were systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.