Archived: Simply Caring Limited - Meridian Centre

The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 200 and associated regulations about how the service is run.

At our last inspection in March 2017 we found one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014 and a further breach of the Care Quality Commission (Registration) Regulations 2009. At the last inspection we found that medicine administration records were not always filled in correctly. We also found that the CQC had not been notified of incidents which affected the service. At this inspection we found that Simply Caring was meeting both these regulations.

The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. Checks were carried out on staff to assess their suitability to work with vulnerable people.

People needed minimal support and prompting with their medicines and support was managed safely. Any risks to people were identified and managed in order to keep people safe.

The service was responsive and people received individualised care and support. People were encouraged to make their views known and the service responded by making changes. The registered manager welcomed comments and complaints and saw them as an opportunity to improve the care provided.

The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and worked to ensure people's rights were respected.

Staff were recruited safely and there were enough staff to make sure people had the care and support they needed.

People and relatives knew how to complain and raise any concerns. People and their relatives did not raise any concerns with us.

People were cared for by staff who knew them well. Staff treated people with dignity and respect. Efforts were made to ensure staff members were able to communicate with people using their preferred language. The manager and staff had a good understanding of equality, diversity and human rights.

The culture within the service was personalised and open. There was a clear management structure and staff felt well supported and listened to.

The vision and values of the service were clearly communicated to and understood by staff. A quality assurance system was in place. This meant the quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted on.

Simply Caring had a comprehensive business continuity plan in place to prepare the service in case of unforeseen circumstances and emergencies.

The service had a registered manager in place at the time of our inspection. 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.

We found one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014, and a further breach of the Care Quality Commission (Registration) Regulations 2009. We found that medicine administration records were not always filled in correctly, for example, we found gaps where medicines may or may not have been administered, with no corresponding note provided to account for the gap. We also found that the Care Quality Commission (CQC) had not been notified of incidents which affected the service.

People who used the service and their relatives told us that they felt safe and believed there were enough staff to meet their needs. One relative told us, "They are really security conscious and make sure we are safe. They are great company for me and provide safe and proper care”.

We found people were cared for by experienced staff who were safely recruited. Staff worked in small teams which meant that the number of staff providing care and support was kept to a minimum and people were supported by staff who knew them well.

There were systems in place to ensure that people who used the service were protected from the risk of harm. Staff had received training in whistleblowing and safeguarding adults, and were able to tell us what they would do if they had any concerns about the people who used the service.

People and their relatives were involved and consulted about the development of their care records. This helped to make sure that wherever possible the wishes of people who used the service were considered and planned for. The staff we spoke with had a good understanding of people’s individual needs and the support they required, and we found that care was delivered consistently by a team of workers who knew how to support people and meet their assessed care needs.

The staff we spoke with had a good knowledge and understanding of the needs of the people they were looking after. People who used the service said they got on well with the care workers and they looked forward to the visits. They told us staff provided respectful, kindly and caring attention to them and they were given choice in how their support was delivered. One person told us, “They always ask me and they listen to what I have to say”. The staff we spoke with demonstrated a good understanding of mental capacity and the legal requirements around this, but when decisions were made on behalf of people who lacked capacity, these decisions were not always recorded.

There was information in people’s care records to guide staff on the care and support needs required and this included information about their likes and preferences. Care plans were written in a way that ensured the person who used the service was central to the planning of care, and gave people who used the service the opportunity to say how they wanted their care to be provided. Plans were instructive with attention to detail and gave staff the information they needed to deliver care whilst supporting people to remain independent. Where risks were identified, care plans instructed staff how best to minimise these risks.

People who used the service told us that they were informed and consulted on any changes to their care plans, and received visits from the care coordinator or registered manager to review their care. We saw that they were asked for their views through a yearly customer service satisfaction questionnaire, but the outcome of this survey was not analysed to determine if there were any trends, or assessed to look at areas which might require improvement.

We saw that staff worked well together and were supportive to each other as well as to the people who used the service. When we spoke to staff they told us that they attended team meetings and were kept informed of any issues or concerns via a weekly memoranda issued from the man office. They received regular supervision and yearly appraisal and told us that they found supervision sessions with the care supervisor to be useful and informative. One care worker told us, “I have good supervision; it can lift me as well as giving me instruction”.

We saw that systems were in place to monitor the quality of the service provided, but these did not always identify issues of concern, such as the administration of medicine.

Systems were in place to help protect people by ensuring that staff were suitably trained in the safeguarding of vulnerable people.

Arrangements were in place to ensure that staff were appropriately supported to enable them to deliver care to people safely.

People benefited from a well- managed agency that had systems in place to monitor the quality of the service provided.

People were protected against the risk of unsafe or inappropriate care and treatment because records required to protect their safety and wellbeing were accurate, up to date and securely stored.

We saw the people's needs were assessed to make sure they received appropriate care. Records provided evidence that people's preferences were taken into account during the planning of their care. We saw that medication records were up to date and staff we spoke with confirmed they received training and felt confident in supporting people with medication.

One person told us they received 'A very good standard of care' and another said 'I am very happy with the service I get'. We heard that people were confident that any concerns they raised would be dealt with promptly. They told us that they were asked for their opinion of the service on a regular basis.

In response to anonymous concerns received earlier this year we saw that the agency's recruitment procedures were now more robust and staff did not start work until all the appropriate checks were completed.