Archived: Moorgate Crofts

Updated 13 September 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 registered 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.

The inspection included a visit to the agency’s office on 14 August 2018. To make sure a registered manager was available to assist in the inspection they were given short notice of the visit, in line with our current methodology for inspecting domiciliary care agencies. The inspection was carried out by an adult social care inspector.

To help us to plan and identify areas to focus on during the inspection we considered all the information we held about the service. This included information gained from people who had contacted CQC to share their experiences about the service. We also requested the views of other agencies that worked with the service, such as service commissioners, social workers and Healthwatch Doncaster. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We were unable to speak with anyone who directly used the service, but we spoke with five relatives to gain their opinion on how the service was operating. We also spoke with both registered managers, the deputy manager and two of the four care workers employed by the service. This was carried out either face to face or on the telephone.

We looked at documentation relating to people who used the service, staff and the management of the service. This included three people’s care records, including medication records, four staff recruitment files, training and support documentation. We looked at how the agency had gained people’s views on the service provided, checks made to ensure company policies were being followed and how concerns and complaints would be managed.

Updated 13 September 2018

The inspection took place on 14 August 2018 with the registered provider being given short notice of the visit to the office, in line with our current methodology for inspecting domiciliary care agencies. This was the first inspection since the service registered with the CQC in September 2017.

Moorgate Crofts, also known as Nurturing Care [the provider is in the process of changing the locations name] is a domiciliary care agency which provides personal care to people living in their own houses and flats in the community. At the time of the inspection the service was supporting 11 people with varying needs in the Harrogate and Ripon area.

The service had two registered managers in post at the time of our inspection. 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 and associated Regulations about how the service is run. The registered managers shared responsibility for the day to day running of the service, supported by a deputy manager.

Relatives we spoke with told us they, and people using the service, were happy with the way the service was run. They said people’s privacy and dignity was respected and staff were caring, polite and attentive.

Systems were in place to reduce the risk of abuse and to assess and monitor potential risks to individual people.

Recruitment processes, to help the employer make safer recruitment decisions when employing staff were in place at the time of the inspection. However, essential checks had not always been made in a timely manner when staff were first recruited.

Staff had access to training and information to help them understand people’s needs, but documentation did not always demonstrate they had initially received a comprehensive, structured induction to the company, and more specialist training on topics such as people’s medical conditions was still to be accessed.

Staff felt well supported by the management team. Periodic one to one support sessions had commenced and were being incorporated into routine practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, there was room to improve the written information in people’s records in relation to their capacity and consent to care, and staffs knowledge on this subject.

Where possible, people were encouraged to manage their own medication, while other people were supported by relatives. Where assistance was required, this was provided by staff who had completed training in the subject. However, further documentation was needed to make sure staff had clear guidance regarding the medicines people were taking.

People’s needs had been assessed before their care package commenced and they, and/or their relatives, had been involved in these assessments. Care plans had been formulated to inform and guide staff in how to meet people’s individual needs and preferences. Relatives we spoke with confirmed their family member’s needs were being met.

People had access to the company’s complaints policy. People told us they had not raised any formal complaints, but when minor concerns had been discussed with the management team timely action had been taken to resolve them.

The service had only been supporting people in the community since January 2018, therefore the process for consulting with people about their satisfaction in the service provided was still being formalised and embedded into practice. In the meantime, the management team were speaking with people on a regular basis and had recently sent out questionnaires to gain people’s views.

The registered manager was checking some processes to make sure staff were following company policies, such as the completing of visit and medication records. However, the system needed to be refined and embedded into practice as it had not highlighted shortfalls in areas such as recruitment checks not being obtained prior to new staff commencing work.

During this inspection we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.