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Inspection carried out on 29 May 2019

During a routine inspection

About the service:

Mountbatton Care Ltd is a family-owned and run domiciliary care agency based in Bootle and Southport, providing care to people in their own homes. At the time of inspection, the service was providing home visits to 99 people with different health and care needs, as well as seven people in supported living settings. This included people with a learning disability or autism.

People’s experience of using this service:

People’s experience of Mountbatton Care was good overall. Out of the 14 people we spoke with, two spoke very highly of the service. One person said, “I do not know what I would do without [staff member].” Another person stated, “They are like extended family”. Three people told us about improvement needs to the service, while nine felt that their care was fine.

On balance, the service continued to meet the characteristics of Good. We found that aspects of how the service was led, connected with the community through charitable work and supported people’s diverse needs, could meet the characteristics of Outstanding. It was clear that the service was led by a passionate team looking to make continuous improvements and managers were very responsive to our feedback. However, we identified improvement needs and some regulatory legal requirements had not been met prior to inspection, which limited our ratings, particularly of ‘Well-Led’.

We found that information available to staff before providing care to people varied between different parts of the service and on the electronic care plans that had been introduced. The management team addressed this issue immediately, but it continued to be an area for development.

There were enough staff to meet people’s needs and provide personalised care. People told us they felt safe overall with the staff support and that calls were on time and never missed.. Staff felt there were enough of them and that generally they had a consistent and reliable team. Staff felt well supported through regular supervision, training and meetings. The service actively involved people and staff in the development of the service through surveys and seeking regular feedback.

The outcomes for people using the service reflected the principles and values of Registering the Right Support, by promoting choice, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. The service was working with a variety of stakeholders to achieve positive outcomes for people and we saw many very positive compliments about the caring support staff provided.

Rating at last inspection:

At the last inspection the service was rated Good (2 December 2016).

Why we inspected:

This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Good rating.

Follow up:

We will follow up on this inspection through ongoing monitoring of the service, through conversations and notifications.

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

Inspection carried out on 5 October 2016

During a routine inspection

This announced inspection took place on 5, 9 & 10 October 2016.

We last inspected this service in September 2014, and the provider was fully compliant at the time of this inspection. Before this inspection, we had received some complaints about this provider and discussed these complaints with the registered manager as part of our inspection processes.

Trimar House is registered with the Care Quality Commission to provide a domiciliary care service to people in their own homes. At the time of our inspection, 57 people were receiving this type of care service. Most of these people who were placed with Trimar House received re-ablement support.

A registered manager was in post.

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.

Everyone we spoke with told us they felt safe receiving care and support from Trimar House.

Staff were able to describe what course of action they would take if they felt someone was being harmed or mistreated in anyway. There was a safeguarding policy in place which all staff had signed, and training records showed staff has been trained in this area.

Risk assessments were clear and concise and contained information regarding how to manage risks appropriately.

People said that staff arrived on time, and they always saw a familiar team of staff, which people liked.

We viewed medication administration records (MAR) sheets for some people we were having their medicines administered by staff, and saw they were accurate and complete. Staff were trained in medication administration, and were subject to regular spot checks to help ensure they were competent with regards to administering medicines.

Staff were recruited safely and checks were carried out on staff before they started work at the service to ensure they were suitable to work with vulnerable people.

Staff completed an induction as well as other training courses selected by the provider to enable them to have the skills needed to complete their role.

The registered manager and staff we spoke with were mostly aware of their roles in relation to the Mental Capacity Act 2005 and associated legislation. Some of the care plans we looked at did not refer to mental capacity. When we asked about these care plans we were told that the person had capacity. The registered manager showed us a training course staff were all booked on to attend regarding the MCA. We saw arrangements were in place to re-visit some people to re-access their capacity.

People told us the staff always made sure they had eaten and drank before they left their home.

Staff told us they would call GP’s or community matrons for people if they asked them to or they felt the person needed a referral making due to them being unwell.

Everyone we spoke with told us they liked the staff, and spoke highly of the staff who visited their homes.

People told us there was a care plan in their homes, which staff used, and they were mostly involved in the completion of their care plan. People said that ‘someone from the office’ would often come out to see them to make sure they were okay.

Care plans with regards to people’s preferred routines and personal preferences were well documented and plainly written to enable staff to gain a good understanding of the person they were supporting. Care plans contained a high level of person centred information. Person centred means completed around the needs of the person, and not the organisation.

We discussed complaints with the registered manager. Complaints had been appropriately dealt with including any changes, which needed to be implemented because of a complaint. Complainants had been appropriately responded to.

Quality assurance procedures we

Inspection carried out on 24 September 2014

During a routine inspection

An adult social care inspector carried out this inspection. We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well led?

Below is a summary of what we found:

Is the service safe?

People�s health, safety and welfare were protected in how the service was provided. People got the support they needed when they needed it and risks to people�s safety were assessed and managed. All staff had received training related to safeguarding procedures. This meant staff had knowledge that helped them recognise when any form of abuse had occurred, or was likely to occur.

Is the service effective?

Care was planned and delivered in line with people�s assessed needs and people�s needs were regularly reviewed to make sure they received the care and support they required.

Is the service caring?

People who received support from Mountbatton Care described staff as �caring� and �kind�. People�s comments included, �I don�t have any complaints�, �staff look after me very well�, �I feel safe because the staff were trained to use the equipment�, �they [staff] support me correctly and are very good� and �everything is fine.�

We saw that staff were respectful and warm in their interactions with people who received support.

Is the service responsive?

The provider had a complaints procedure in place. All people who received suport had a copy of the procedure in a �service user handbook�.

The service worked with other agencies to make sure people received the care and treatment they needed. GPs and other health professionals were referred to promptly when people required support with their health care needs.

Is the service well led?

We saw that the provider had quality assurance audits [checks] in place. Service users� views on the service they received was gathered through questionnaires.

Staff we spoke with felt supported by the manager. Their comments included, �Enjoy working here�, �Good training programme�, �Feel supported� �No complaints�.