Archived: Mega Resources Nursing & Care Services

Mega Resources Nursing and Care Services is a home care agency supporting people who live in their own homes. At the time of our inspection 66 people used the service.

When we last inspected the service in April 2015 the service was rated ‘Good’.

The inspection took place on 19 June 2017 and was announced. We gave the provider 48 hours’ notice because the service is a home care agency and the registered manager is often out of the office supporting staff or visiting people who use the service. We needed to be sure they would be in.

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.

The provider had policies and procedures for keeping people safe. Staff received safeguarding training they put into practice and staff were periodically observed to monitor their practice. The provider had a recruitment procedure that ensured as far as possible that only staff suited to support people who used the service were employed. Prior to our inspection an incident had occurred. The registered manager took all appropriate steps and made the appropriate referrals to different agencies as soon as they became aware of the incident. We have made a recommendation about this.

People’s care plans included risk assessments of activities associated with their personal care routines. The risk assessments provided information for care workers that enabled them to support people safely but without restricting people’s independence.

Enough suitably skilled and knowledgeable staff were deployed to meet the needs of the people who used the service. Staff arranging home care visits were knowledgeable about people’s needs and arranged for staff with the right skills and knowledge to visit people.

People were supported to take their medicines at the right times.

People were cared for and supported by care workers who had the appropriate training and support to understand their needs. People we interviewed spoke about staff in complimentary and positive terms, though one family were displeased with the support their relative experienced.

Staff were supported through supervision, appraisal and training. They received training to help them understand about medical conditions people lived with. Staff valued the support that they received because it helped them carry out their roles.

The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. People were presumed to have mental capacity to make decisions about their care and support unless there was evidence to the contrary. The registered manager attended to this after we brought it to their attention. Staff had awareness of the MCA. They understood they could provide care and support only if a person consented to it.

Care workers either prepared meals for people or supported people to make their meals.

They supported people to attend healthcare appointments and to access health services when they needed them.

Care workers were caring and knowledgeable about people’s needs. People were consistently supported by the same care workers. When staff rotas were prepared care workers were `matched’ care workers with people who used the service which supported them to build caring relationships.

People who used the service were involved in decisions about their care and support. They received the information they needed about the service and about their care and support. People told us they were always treated with dignity and respect, though that had evidently not been the case with one care worker.

People contributed to the assessment of their needs and to reviews of their care plans. People’s care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to.

The provider had arrangements for monitoring the quality of the service. There were arrangements for monitoring punctuality and duration of home care visits which were being improved. The provider had begun a review of how they monitored whether people were safe.

Further information is in the detailed findings below.

People who used the service told us it was important to them that they knew which care worker would be visiting them. One person told us, "They're very good. they do everything, they ask me what I want. They are always on time and I always know who is coming. I've no complaints."

A relative told us, "It's a very good service. The carers are always on time. They are very pleasant. We get the same carer on weekdays and a different one at weekends but we always know who is coming. That is very important to us. We know it makes our mum feel safe." Another relative told us, "I can't fault the service. They have been very good. My mum feels safe with the carers. We have a team of two to three carers that come, my mum has got to know all of them."

We found that people who used the service and their relatives had good reason to be confident about the service. The service was well led.The service had effective procedures for delivering personalised care and support. The service also had effective procedures for checking that people were satisfied with the quality of care they experienced.

The provider was registered to provide nursing care in anticipation of providing that regulated activity in the foreseeable future. at the time of our inspection only personal care was provided.

We found that people were generally satisfied with the quality of care they had experienced. People were complimentary about the care workers who visited them. Comments in an annual survey included; `they immediately took on board and understood how we felt' and `all the carers we have met are good and go the extra mile to be helpful.' At the time of our inspection seven of the 18 people who used the service had participated in the survey. Six people had reported that care workers had visited them at times they expected. One person said that care workers were punctual only `sometimes.' All respondents said that care workers had treated them with dignity and respect. Six people said that care workers carried out all of the routines required by their care plan; and one said that not all care routines had been carried out. We found that care worker's notes of their visits lacked sufficient detail to provide an assurance that all care routines had been carried out.

We found that he service did not have an effective process for ensuring that care workers made visits at times that people expected.