Archived: Medical Partnerships Limited

Medical Partnerships Ltd is a small domiciliary care agency (DCA) registered to provide personal care and support to older people living in their own homes. The service does not provide nursing care. At the time of our inspection 29 people were using the service.

A registered manager was in post who was also the owner of the business. 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.

Staff told us they had received the training they required to be able to carry out their role and were well supported by management; however we found that there were no formal systems in place for staff supervision and appraisal and completion of staff training had not been effectively monitored. We discussed this with the registered manager who immediately put into place a supervision and appraisal plan to ensure staff received formal supervision, including observation of practice and appraisal of their performance.

People felt safe. Staff had received training in safeguarding adults and understood the signs of abuse to look out for and how to report any concerns including whistleblowing if appropriate. Risk assessments were in place to keep people and staff safe. Safe recruitment processes were followed and there were sufficient numbers of staff to meet people’s needs. People received care from a consistent staff team.

People received a service which was based on their personal needs and wishes. Care plans were personalised and provided staff with sufficient information to meet people’s individual needs. Staff were caring and kind and knew the people they cared for well and treated people with dignity and respect.

Although records showed 40% of staff had not received training in the Mental Capacity Act (MCA) 2005, all the staff we spoke with had a basic understanding of the principles of the MCA and understood the need to obtain consent from people before providing care and to respect the rights of people to make their own decisions.

The registered manager had a number of ways of gathering people’s views and there were a number of informal quality monitoring processes in place to help ensure the service was running effectively.

The service had a complaints policy and people and relatives told us they were confident any concerns would be listened to. None of the people we spoke to during the inspection had any complaints about the service.

Staff felt valued and supported and enjoyed working for the service; they shared the registered manager’s vision and values and were committed to providing a high quality service to people.

Our inspection team was made up of one inspector. We spoke with two people who used the service, relatives of four other people who used the service, the manager and three staff. We looked at four people's care records and associated documents. Other records viewed included training records, health and safety checks, medication records, quality assurance audits and satisfaction questionnaires completed by the people who used the service, relatives and staff who were involved with the people who used the service.

We used the evidence we collected during our inspection to answer five questions. This is a summary of what we found:

Is the service safe?

A relative of person who used the service told us, 'My X is very at ease with the cares that she has, she enjoys having banter with them.'

We saw that records contained detailed assessments of people's needs that had been carried out prior to the start of the service. People told us that they had been involved in planning their care with the provider. One person said, 'I negotiated the times of my visits with the office.'

Staff received regular training in core areas to ensure that they were skilled and competent to meet the needs of the people who used the service. These were updated annually or when a person's needs changed and staff needed to gain further knowledge about their condition. This ensured that the staff had the relevant skills and knowledge to meet people's individual needs.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We saw that all staff had completed refresher training in the last year for safeguarding of vulnerable adults, and the staff we spoke with were able to describe what abuse was and what they would do if they were to witness or suspected abuse.

Is the service effective?

One person who used the service told us that they were happy with the care they received and felt their needs had been met. A relative told us, 'The staff understands their relatives care needs very well.'

Is the service caring?

One person who used the service commented, "The staff are very good" Another person said, 'I couldn't get a better service from anyone else.'

People's preferences and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We saw people had an opportunity to provide feedback on the quality of the service they received. Questionnaires were sent as part of our ongoing commitment to quality assurance on 5 June 2014. The questionnaires were sent to all 29 current clients and 22 had been returned to the office. The comments received were mostly positive and included comments such as 'Medical Partnerships give me all the care I could wish for and more' the girls are helpful and pleasant especially X and X.' And "I am completely happy with the service provided. The girls are always cheerful, happy and very good at dealing with my parents. I am kept informed at all times.'

Is the service well led?

A relative told us, 'The management team are excellent, very organised and responsive.' Staff told us they were clear about their roles and responsibilities and that they received excellent support and supervision from the manager. Staff had a good understanding of the aims and objectives of the service. This helped to ensure that people received a good quality service at all times.

The service had a quality assurance system in place and records seen by us showed that regular audits had taken place in areas such as reviewing care plans and risk assessments, training and supervision.

The provider had a complaints policy and procedure, which was given to people when they started using the service which was a part of the welcome pack. We saw that two people had raised concerns and that the manager had taken immediate action to address them.

People who use the service said, 'They are such lovely, polite girls, I really look forward to them coming.' 'Some days I can't wash myself and they will do it all, I feel really safe with them.' 'I have to give them 10 out of 10, we couldn't live our lives without what they do and they do it so well ' it's such a comfort.'

People's needs had been fully assessed and their care plans clearly described the support that they needed. Care plans and risk assessments had been regularly reviewed and updated to reflect people's changing needs. There was enough qualified, skilled and experienced staff to meet people's needs. Relatives of people who use the service told us that the records kept in people's homes were well maintained.

People received safe, effective and compassionate care from a well led service that responds quickly to their changing needs.