Background to this inspection
Updated
25 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team comprised of one inspector and one assistant inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
The service was registered with us on 10 October 2018 and this is the first inspection. Inspection activity started on 16 July 2019 and ended on 19 September 2019. We visited the office location on 16 September 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We contacted Healthwatch, this is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service.
During the inspection
We spoke with three people who used the service about their experience of the care provided. We spoke with three relatives. We spoke with four members of staff including the, registered manager, deputy manager, and two care workers.
We reviewed a range of records. This included three people’s care records and three medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
25 October 2019
About the service
Milberry Care Agency is a domiciliary care agency providing care to people in their own homes.
The service was supporting four people at the time of the inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
We found staff recruitment checks were not always carried out fully, and there were no records of staff interviews.
There were insufficient risk assessments in place to keep people safe from harm.
People’s needs were assessed however there was a lack of personalised information in care plans.
Medicines were managed safely. Staff received training and supervision.
Staff were caring and supported people’s needs. People were involved in making decisions about their care. People’s privacy and dignity was maintained, and staff treated people with respect.
People were supported to maintain their independence.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There was no end of life planning or staff training. We have recommended the service records people’s end of life wishes relating to protected characteristics, culture and spiritual needs.
The service worked well with other agencies. The service was open and understood duty of candour. There were audits in place, but actions were not always clearly followed up for improvements to be shown. The management team were receptive to feedback throughout the inspection and responded quickly to concerns. They told us they were committed to improving the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This service was registered with us on 10 October 2018 and this is the first inspection.
Why we inspected
This was a planned inspection based on our schedule for new services.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report. We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to insufficient checks around staff recruitment.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.