Archived: Moorlands Home Link

The service was last inspected in July 2013 when we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Moorlands Home Link is a domiciliary care agency with charitable status providing care for people in their own homes. Around half of the people who used the service received weekly support with bathing, other people received support with personal care through several visits each day. On the day of our inspection visit the agency was providing support to 45 people and employed 13 members of care staff.

The charity also provided a number of other services in the community. These included a friendship and support service to people who were elderly or needed support to go out. A day centre run in a local community centre, meals on wheels, transport arrangements via minibuses and trained volunteers.

The service did not have a registered manager at the time of our inspection visit. 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. As there was no registered manager in post at the time of our visit we spoke to the executive manager and the acting manager, who were managing the service in the absence of a registered manager.

The provider had recently changed their company status which came into effect in 2015. However, the provider had not re-registered their service with CQC when their legal status changed. This meant the provider was operating under an out of date registration with us. We have asked the provider to register their service under their new legal status without delay.

Processes to manage the risks to people’s safety required improvement. Care records did not provide staff with enough information to consistently identify and manage risks associated with people’s care. Medicine procedures required improvement to ensure care staff recorded the administration of all prescribed medicines.

Care records were not sufficiently up to date to provide staff with the information they needed to ensure people received consistent care. The executive manager had conducted a recent audit on care records and identified a need to update all care records, using a new format which gave staff more information on the needs of people they cared for. New care records were being introduced over the next four months.

There were systems to monitor and review the quality of service people received and to understand the experiences of people who used the service. This was through regular communication with people and staff, surveys, spot checks on care staff and a programme of other checks and audits. Where issues had been identified, the executive and acting manager were implementing improvements. However, auditing procedures were not always sufficiently detailed to ensure issues for improvement were identified. For example, auditing procedures had not highlighted the need to record all the medicines administered to people.

People told us they felt safe using the service. Care staff understood how to protect people from abuse and keep people safe. The character and suitability of care staff was checked during recruitment procedures to make sure, as far as possible, they were safe to work with people who used the service.

There were enough care staff to deliver the care and support people required. People told us care staff usually arrived around the time expected and stayed long enough to complete the care people required. People told us care staff were caring, kind and knew how people liked to receive their care.

Care staff received an induction when they started working for the agency to give them the skills they needed to care for people effectively. The provider ensured staff continued to have the right skills and attitudes for their role, by offering staff regular updates to their training, observing their practice and monitoring their performance.

Staff were supported by managers through regular meetings. There was an out of hours’ on call system in operation which ensured management support and advice was always available for care staff during their working hours.

The executive and acting manager understood the principles of the Mental Capacity Act (MCA), and care staff respected people’s decisions and gained people’s consent before they supported people with personal care.

Staff, people and their relatives felt the acting manager was approachable. People knew how to complain and information about making a complaint was available for people in the service user guide each person had in their home. Care staff said they could raise any concerns or issues with the executive or acting manager, knowing they would be listened to and action would be taken.

We found there was a breach of Regulation 17 HSCA 2008 (Regulated Activities) Regulations 2014 Good Governance. You can see what action we told the provider to take at the back of the full version of the report.

People told us that they were happy with the care provided. One person we spoke with told us, 'I am very happy I really appreciate the service'. Another person told us, 'It's an excellent service. The staff are very good, reliable too. I couldn't manage without them'.

We found that improvements had been made to the information detailed in people's care records to ensure that staff were given appropriate information and care was planned and delivered in a safe way.

We saw that the provider had up to date policies to ensure that staff had guidance to follow if they felt that a person who used the service was at risk of harm. Staff we spoke with knew the different signs of abuse and their responsibilities to report any concerns.

People using the service told us their privacy and dignity were respected. Comments included, 'They always knock and they are all helpful and friendly. I never feel rushed I can take my time.' Another person said, 'They let me do what I can for myself and I choose what I would like to wear.'

People told us they received the care and support that met their individual needs and were happy with the staff team that supported them.

We found the registered provider was delivering a service which respected people's views but the care records required further information to demonstrate the service was delivered in a safe way.

We found policies, procedures and training needed to be improved upon to ensure vulnerable adults were suitably protected.

We looked at the recruitment procedures for staff and found that suitable systems were in place.

The provider had systems in place to check on the quality of the care people received. We saw complaints would be responded to, and the registered provider acted upon information to improve the service.