Archived: Mayfair Homecare - Newbury

Not everyone using Mayfair Homecare – Newbury receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Mayfair Homecare – Newbury does not currently have 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 previous registered manager had left in January 2019. The new manager is in post and currently in the process of applying to be registered.

People’s experience of using this service:

People were supported for by a consistent staff team who were kind and caring and appropriately trained. Staff had good relationships with people and knew them well. People were encouraged and supported to maintain their independence. They spoke highly of the care and support they received. “The carers are brilliant, I can’t fault them.”

Appropriate numbers of staff were employed, however safe recruitment practices had not always been followed. The current provider had bought out the previous provider of the service in 2016, a number of staff transferred across to the new service. However, the new provider had not assured themselves that people employed by the previous provider had been recruited safely.

Feedback was sought from people and staff through meetings and questionnaires. People told us they felt comfortable in raising any concerns or issues.

Care plans were person centred and detailed people’s support needs. However, records were not always accurate. Some risk assessments were inaccurate which meant people were at potential risk because staff did not have the most appropriate information and guidance. Quality assurance audits were carried out regularly. Some of those completed were inaccurate, recording information as being present when it was not. Branch audits were also regular. Specific issues identified were addressed but the service failed to identify that some specific issues were actually more widespread.

We identified two breaches of the regulations. Safe recruitment practices were not always followed and governance systems were not effective. You can see what action we told the provider to take at the back of the full version of the report.

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

Rating at last inspection: Good (July 2017).

Why we inspected: This was a responsive, focussed inspection prompted by a notification of an incident in which a person using the service was subject to alleged abuse. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident.

However, the information shared with CQC about the incident indicated potential concerns about the management of safe care and risk. This inspection examined those risks. This has been reported on under the safe and well led domains only.

At the last inspection, the service was rated ‘Good’ overall, with ‘Requires improvement’ under ‘Well-led’. Concerns had arisen with regard to the reliability and timeliness of care calls and the ability and effectiveness of the management to monitor and address these concerns.

At this inspection we found the service remained ‘Good’ overall and was now rated ‘Good’ across all areas. The registered manager and provider had taken steps to improve the areas of concern. These included the establishment of an effective call scheduling and monitoring system and better oversight and governance of the effectiveness of this and other aspects of the service provided. The views of people and relatives were being sought more systematically to assist management to provide an adequate response to any issues raised with them. The service had taken positive steps to improve recruitment and retention of staff.

People felt safe and well looked after by the staff who visited them. They felt staff were competent, treated them with kindness and respected their dignity and rights. People felt consistency in terms of the staff providing their support, had improved recently. This had led to increased confidence that staff knew their needs and how they wanted to be supported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff received a thorough induction and training in all relevant areas which was regularly updated to ensure they maintained knowledge of current best practice. Staff received ongoing support in their work and personal development through regular supervision, annual performance appraisal, spot checks and other observations of their care practice.

People said the service was flexible and responsive to changing needs and felt confident in calling the management or office staff if they had a concern.

Further information is in the detailed findings in the full report.

Below is a summary of what we found. The summary describes what people using the service, and the staff told us, what we observed and the records we looked at.

On the day of our inspection Silverdale Care Services was providing support for 140 people. We visited three people and two relatives in their home and spoke with three people and a relative on the telephone. We also spoke with five members of staff, the registered manager and the proprietor.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

The recording of medicines was not safe. This meant that the provider could not demonstrate that the staff were able to ensure that people were able to take their medicines at the times they needed them and in a safe way. A compliance action has been set for this and the provider must tell us how they plan to improve.

The provider did not have an effective recruitment and selection processes in place. This meant that people were at risk as the provider had failed to carry out relevant checks when they employed staff and there was no risk assessment or method of checking that the person was safe. A compliance action has been set for this and the provider must tell us how they plan to improve.

We saw that when staff commenced work with Silverdale Care Services staff completed a five day induction programme followed by shadowing experienced staff. Staff confirmed they had completed an induction programme and shadowed experienced staff until they were confident

Is the service effective?

People we spoke with were positive about the service they received. One person told us that the, 'The girls are really good'. A relative told us that they were 'Overall quite happy with the service.'

Speaking with staff it was evident that they understood individuals' care and support needs. We saw that care plans were based on people's assessed needs. However staff were not signing and dating the sign and read sheets to confirm that they had read the person's care plan, this meant that people were at risk of receiving unsafe or inappropriate care.

Is the service caring?

People told us that they were happy with the care they received and felt their needs had been met. In people's care plans we saw that there was information about what they needed help with and how staff should support them. One person told us: 'The staff are very good, very polite and helpful.'

Is the service responsive?

We saw that people's visits were tailored to people's needs. One person we spoke with said: 'if they wanted staff to visit at a different time this was accommodated.' A relative told us they had increased the length of the visits during the summer so staff could assist (name) with fluids'.

The provider undertook a quality survey in January 2014. The survey showed that people using the service were unhappy about the timing of the calls and not being notified when staff were running late. There were also 34 complaints recorded since January 2014, the majority had where related to the timing of the calls and not being notified when staff were running late. During our visit one relative commented that this had improved.

Is the service well-led?

The service had quality assurance systems in place. These included undertaking spot checks to monitor staff performance. The provider undertook quality assurance audits to gather feedback from people about how the service was run. We saw that complaints were logged and that these had been followed up. One relative we spoke with told us that when they complained their concerns were dealt with.

At our inspection on 14 March 2014 we found the provider had made significant improvements and was now meeting the required standard. The registered manager told us that as part of their action plan they had appointed a new area manager and deputy manager for the Newbury area. We examined the service computer records and staff files, which demonstrated that staff had received quarterly supervisions and spot checks, together with an annual appraisal. This was confirmed by staff we spoke with. Staff told us that morale had improved significantly since the appointment of the new manager and deputy manager, who were approachable and willing to listen to their concerns.

We looked at care plans and found that these contained all of the relevant information to enable staff to deliver the agreed amount of support, in the way that people preferred. One relative of a person using the service said, 'The care is excellent. They are amazing ladies'.

Staff in different roles all showed a practical awareness of their responsibilities in relation to safeguarding and whistleblowing and gave examples where they had raised concerns. We looked at these concerns and found that they had been reported, recorded and investigated properly.

Medicines were prescribed and given to people appropriately. The service user guide and medication policy gave clear information about what staff may or may not do with regards to medication.

The provider did not complete any spot checks, supervisions or appraisals. This meant they could not ensure that staff were properly supported to provide care and treatment to people who use the service.

The agency completed an annual survey to monitor the quality of care provided. The results of the most recent survey covering 2012 found that people were treated with dignity and respect and that they were happy with the standard of care they received.

People we spoke with told us that they had chosen the care and support they received and how it was to be given to them. They were able to make choices about their life and lifestyle and were supported to make decisions for themselves. They said that the manager and staff talked to them about how they wanted their needs to be met and respected their decisions.

Most people we spoke with were satisfied with the quality of their care and treatment. One person said, ' The care is excellent.' Another person using the service said, 'The carers are very good, very caring. I regard them more as friends.' However one person was very dissatisfied with the service provided and said, 'The standard is poor. It's pretty shoddy.'

People were protected from unsafe or unsuitable equipment because the provider made sure that appropriate, properly maintained equipment was available and used safely.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work. Most of the people using the service we spoke with were happy there were enough staff with the right qualifications to meet their needs. Some people we spoke with were concerned that sometimes the staff were rushing to get to another service user.

People had their comments and complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint.