M C Care Solutions Ltd

Updated 25 October 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was undertaken by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service three weeks’ 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. We had originally envisaged giving two days’ notice, but the registered manager was on leave when we had planned to visit.

Inspection activity started on 24 August 2022 and ended on 27 September 2022. We visited the location’s office on 7 and 13 September 2022.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people and four relatives on the telephone and with four staff, including the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We viewed three care records, three staff files and various records relating to the management of the service, including incident and accident records, staff training records, quality assurance records and a recent commissioner’s contract monitoring report.

Updated 25 October 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right Support, Right Care, Right Culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

M C Care Solutions Ltd is a domiciliary care service providing personal care to adults in their own home. At the time of our inspection there were 21 people using the service.

Not everyone who uses the service receives 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

Right Support:

People and relatives said they felt listened to regarding their care and were happy with the care they or their loved one received. They told us staff knew and understood them as people.

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.

Staff worked in a way that promoted people’s independence.

People and relatives confirmed staff obtained the person’s agreement before providing care, where the person was able to consent. In the event of concerns about a person's ability to consent to their care and they had no legally authorised representative, staff followed the requirements of the Mental Capacity Act 2005 to provide necessary care in the least restrictive way possible.

The registered manager was careful not to take on more care packages than current staffing levels could sustain, in order that staff had time to provide care and support in line with people’s needs and preferences.

Risks to people and to the staff supporting them were identified, assessed and were managed in the least restrictive way possible, in line with people’s preferences.

The service worked proactively with health professionals to help achieve the best outcome for people. The registered manager made appropriate, timely referrals to relevant professionals and acted swiftly on their recommendations.

Right Care:

People and their relatives told us staff were kind, caring and respectful. They said staff worked efficiently but did not rush care.

People and relatives said they felt safe with and able to trust the staff who supported them or their loved one. Staff had the necessary training and skills to be able to work safely and effectively. The registered manager and staff understood their responsibilities for keeping people safe from abuse and neglect.

Staff had access through the computerised care planning system to the up-to-date information they needed about people’s care. We have made a recommendation about care planning for people’s health conditions.

The care planning system alerted the registered manager and office staff in the event care had not been provided as scheduled. The registered manager monitored these alerts throughout the day and ensured people received their care.

Communication needs were assessed and were included in ‘hospital passport’ documents shared with health professionals in the event a person needed hospital admission.

Where staff were responsible for assisting people with medicines, people received them as prescribed.

There was a plan for emergencies that might affect the safe running of the service, such as staff shortages.

Whilst the service had a clear recruitment procedure, full recruitment checks and records were not in place for one member of staff. The management team swiftly rectified this. We have made a recommendation about recruitment checks.

Right Culture:

The provider and registered manager fostered an open, person-centred, inclusive culture within the service, drawing on their experience of supporting people with a learning disability and autistic people. This was reflected in the way care and support was planned and the approach staff took towards people.

The registered manager operated an open-door policy for people, relatives and staff. People, relatives and staff knew the registered manager and found him easy to approach.

People and staff felt confident to approach the registered manager in the event of any concerns. The registered manager and office staff promptly addressed and resolved any grumbles and queries. The service had never received a formal complaint.

The registered manager was open and honest with people and their relatives when things went wrong.

The registered manager had a current overview of the service, through constant monitoring of the computerised care recording system, quality assurance audits, the results of people’s and relative’s satisfaction surveys and through frequent informal conversation with people, relatives and staff. We have made a recommendation regarding auditing.

The registered manager and staff understood their roles and responsibilities. Staff had monthly supervision with a member of the office team, where they discussed their work. There were regular unannounced spot checks, where senior staff observed care staff during a care call to ensure they were working consistently with the provider’s values and procedures.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This service was registered with us on 15 January 2021 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 27 September 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Recommendations

We have made recommendations about recruitment checks, care planning for people’s health conditions and auditing.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.