Archived: Meadow Home Care Services Limited

We visited the offices of Meadow Home Care Services on 27 January 2016. We had told the provider 48 hours before the visit we were coming so they could arrange for staff to be available to talk with us about the service. When we arrived at the location address 41 Warwick Road we found the service had moved. We went to the new location at the provider address. We had been informed by the provider they had moved the provider address to 8-10 Ulverley Green Road, Solihull, but had not been informed they had moved the location. This meant the provider was in breach of the condition of registration that allows them to operate from a specific location. The registered manager took immediate action to submit the required applications to us.

The information in this report relates to the service provided from the provider address at 8-10 Ulverley Green Road, Solihull and not the location, 41 Warwick Road as stated on the front of this report. The change of address had not affected the service provided by Meadow Home Care.

The service has 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.

Not all care workers had received the induction and training required to meet people’s needs safely and effectively. Care workers practice was not being checked to make sure they worked in line with the provider’s policies and procedures.

People and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. There were processes to minimise risks to people’s safety; these included procedures to manage identified risks with people’s care and for managing people’s medicines safely. Checks were carried out prior to care workers starting work to ensure their suitability to work with people who used the service.

The managers had limited understanding of the principles of the Mental Capacity Act (MCA) and their responsibilities under the Act.

Care workers respected people’s decisions and gained people’s consent before they provided personal care. People told us care workers were kind and caring.

There were enough care workers to provide care to people and most people had consistent care workers. People had different experiences about the times care workers arrived; most people received their care around the time expected. People said care workers stayed the agreed length of time and knew how they liked to receive their care.

Care plans and risk assessments contained relevant information for care workers to help them provide the care people required. People knew how to complain and were able to share their views and opinions about the service they received. Care workers were confident they could raise any concerns or issues with the managers and felt they would be listened to.

There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. However, the registered manager and other manager’s in the service did not have sufficient knowledge and understanding of their regulatory responsibilities. The registered manager’s overview of the service was not sufficiently robust to ensure the service always operated effectively and safely.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The expert by experience gathered information from people using the service by telephoning them to find out if their needs were being met by the service. We received feedback from fifteen people who used the service. Of these fifteen people, feedback was provided by relatives for ten of these people.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

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

Is the service safe?

We saw people's care had been arranged according to their personal needs.

We found there was a process in place for managing risks associated with people's care.

People we spoke with told us they had regular reviews to make sure care plans were accurate and up to date.

People who were assisted to take medicines received their medication as prescribed.

Two people received assistance using a hoist. Both people felt safe and indicated care workers were competent in using the equipment.

We found staff completed the training required to work with people in a safe way.

We found people who used the service felt confident any concerns or complaints would be investigated by the service.

Is the service effective?

People told us the care they received met their needs.

People told us they had been involved in planning their care.

Staff we spoke with had a good understanding of the needs of people who used the service.

We saw care plans were reviewed and updated regularly so care staff could continue to provide the correct level of support.

People said care workers arrived around the time expected and stayed long enough to do everything they needed. Some people told us they had experienced late calls. We were told work schedules had been revised to make sure call times were more consistent. Staff we spoke with said they were allocated regular clients and were allocated sufficient time to carry out all the tasks required.

We found staff had regular supervision and their practice was observed to make sure they provided care and support in line with the provider's policies and procedures.

People said they felt consulted and listened to.

One relative told us that having carers gave her piece of mind that someone was ensuring her mum is ok.

Is the service caring?

Care plans contained information about people's likes and preferences. This made sure people received care in a way they preferred.

People who used the service indicated that the carers were kind and understanding. Comments from people included, 'The carers are very kind and really talk to her.'

We asked people if care workers were polite and respected their privacy. People told us how care staff closed the curtains when providing care. One person told us 'they wrap my mum up so they preserve her dignity when she's being washed."

We asked people if care workers treated them in the way they liked. Everyone indicated that people were treated as individuals, Comments from people included,

'They (the care workers) look after me very well.'

'I like how they talk to me and the way they behave towards me.'

Is the service responsive?

People told us they were asked for their views and opinions during reviews and any changes were recorded and acted on.

One person told us they had contacted the office to see if their relatives evening visit could be made later than 7pm but was told it wasn't possible at the present time. The person they spoke with told them they would do their best to re arrange the time as soon as possible.

People told us that concerns were listened to and acted on. For example one person had asked for a carer not to come back which had been satisfactorily sorted. We were told; there wasn't anything 'wrong' they just didn't get on'.

People told us that care staff noticed when their needs changed and took action.

Is the service well led?

The service had a clear management structure in place and senior staff spoken with understood their role and associated responsibilities.

We found the service had an effective quality assurance system in place. This included regular reviews with people who used the service, telephone conversations and satisfaction questionnaires.

Staff received regular supervisions that included work based observations to make sure they worked in line with policies and procedures.

The service had auditing procedures in place to make sure staff provided care to people as recorded in their care plans and worked in line with the provider's policies and procedures.

People who used the service and care workers we spoke with told us they were able to speak with staff in the office and raise any issues or concerns they had.

People who used the service told us they were satisfied with the service they received. Comments from people included,

'It's a pleasure to have them (the care workers) in my home."

'They are the most amazing carers I've come across."

'We're extremely pleased with them."

We spoke with the care manager, the quality monitoring officer, five office based staff and three care workers during our visit. We also spoke with 15 people who used the service or their relatives to find out their views about Meadow Home Care.

We saw peoples care needs had been assessed and people had a care plan completed. The care files we looked at did not provide staff with sufficient information about the care and support people required to meet their needs and maintain their safety.

People told us care workers maintained their privacy and treated them with respect. One person told us, 'They are respectful; they take me to the bathroom and shower me. They wrap me in a towel straight away. I can't do anything for myself.'

Staff knew what to do to keep people safe. The care manager understood her responsibility for referring safeguarding concerns for investigation.

People we spoke with said their care workers were friendly and polite. We asked people if they had consistent care workers. People had different experiences but generally people said they were allocated regular care workers. We were satisfied care workers had been recruited safely and on the day of our visit there were sufficient care workers to meet the needs of people who used the service.

We looked to see if staff were trained and supported to carry out their role effectively and safely. We found care staff had not received the training and support required to continue to support people in a safe way.

The service had a process in place to assess the quality of care given to people. We found the monitoring procedures in the service were not sufficiently robust. This meant people who used the service could not be sure about the quality of the service they received.

Care staff respected privacy and dignity when caring for individuals. Care plans were personalised and included preferences and choices.

Care staff gave consistent care, and stayed long enough to do everything that was needed. People did not feel rushed during their call. People confirmed that care staff were polite, professional and very friendly.

Records were detailed and comprehensive. The agency had systems in place to monitor the care provided and to manage identified risks.

There were no current safeguarding concerns or complaints and we had not received any negative comments about the service.