Maycare

Updated 12 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 17 January 2023 and finished on 9 February 2023. We visited the location’s office on 17 and 19 January 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

At the site visit we spoke with the registered manager and two office-based staff. We reviewed 12 people’s care and medicines records, staff recruitment files and audits. After the site visit we spoke with 8 people, 5 relatives, 6 staff and 1 health and social care professional.

Updated 12 April 2023

About the service

Maycare is a domiciliary care service providing personal care and support to people in their own homes. At the time of our inspection there were 42 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The provider had made some improvements to monitor people’s care call visits and completed daily monitoring, however we could not be assured people consistently received support from two care staff where this was identified. Records showed people did not always get the visits as they were commissioned by the funding authority and which they were assessed as needing. We were not assured people always received the care and support they needed in ways which met their assessed needs and preferences.

The provider had implemented a system of auditing since the last inspection. The registered manager completed a daily audit which identified, for example, if there had been missed visits or medicines concerns. Weekly meetings were held between the registered manager and office management staff. However, the provider had not identified the concerns we found during this inspection.

The provider had improved the way they recruited new staff but needed to ensure their policy met the regulation.

People were supported with their medicines when necessary and the provider had improved their monitoring of missed medicines. Appropriate action had been taken in response to errors and the number of medicines issues had reduced. Staff had received training in administering medicines and most had their competency assessed by senior staff who had undertaken advanced training for medicines administration.

The provider raised safeguarding concerns with the local authority when these were identified. However, we identified one issue which the provider had not identified as a safeguarding concern. The provider subsequently notified the local authority.

Risk assessments identified when people needed the support of two staff. However, for one person the risk assessment had not been updated to show their care needs had changed and they needed the support of two staff. The provider had a system in place to assess people’s needs before offering them a service.

We received mostly positive feedback from people, their relatives and staff about the service provided. The provider sought the views of people using the service through reviews both over the telephone and face to face. People were supported by staff who were trained and used personal protective equipment such as disposable aprons and gloves, appropriately. Some people were assessed as needing support with fluids and meals and this was detailed in care plans. Records showed people consented to their care and support.

People told us they felt staff were kind when supporting them. People and their relatives told us they could make decisions about their care and staff respected their decisions. People and their relatives told us they felt their privacy and dignity was respected by care staff. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People had care plans in place which detailed their care and support needs and preferences. The registered manager told us they ensured people were provided with information in ways they could understand. The provider had a complaints procedure in place and people told us they could complain and were happy with the response.

The provider had systems in place to investigate where things had gone wrong and took action to reduce the risk of this happening again. Staff and management liaised with other agencies and health and social care professionals when necessary. The provider had regularly engaged with the local authority adult services.

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

Rating at last inspection and update

The last rating for this service was requires improvement (report published 25 August 2022).

At this inspection we found the provider remained in breach of regulations. Whilst the provider is no longer in breach of regulation 12 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, not enough improvement had been made at this inspection and the provider remains in breach of regulation 9 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

This inspection was undertaken to follow up on action we told the provider to take at the last inspection. We conducted a comprehensive inspection to enable us to gain a view of the complete service as the previous inspection focused on the key questions Safe and Well-led.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Maycare on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to people not always receiving the care and support they need and the governance of the service at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.