Archived: MCJA St. Helens Office

Updated 18 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 11 & 12 October 2017 and was unannounced.

The inspection team consisted of two adult social care inspectors and an expert by experience. An expert by experience is a person who has expertise in a particular area, in this case, care of older people at home.

Before our inspection visit, we reviewed the information we held about MCJA. This included notifications we had received from the provider about incidents that affect the health, safety and welfare of people who used the service. We accessed the Provider Information Record (PIR) we received prior to our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with 20 people who used the service via telephone, four care staff, one of the owners who was visiting the service at the time of our inspection, the deputy manager and the registered manager. We spoke with two relatives who were visiting the office at the time of our inspection. We looked at the care plans for four people and other related records. We checked the recruitment files for four staff. We also looked at other documentation associated to the running of the service.

Updated 18 November 2017

This inspection of MCJA took place on 11 & 12 October 2017. This inspection was unannounced.

Our last inspection of MCJA took place in April 2016. During this inspection we found the service was in breach of regulations relating to the governance of service. The service was rated as Requires Improvement. Following our inspection in April 2016, the provider sent us an action plan detailing what steps they were going to take to ensure the breach was met. We checked this during this inspection and found that the service had made the required changes.

MCJA is a domiciliary care agency based in St. Helens. It offers care and support to around 220 people in their own homes including personal care. The agency has offices based in St. Helens and is registered as a supplier of services to St. Helens Local Authority. They employ around 65 support staff.

During our last inspection in April 2016 we found the service in breach of regulations relating to governance. This was because regular audits (checks) were not routinely performed on medication which meant people were at risk of not having their medication managed appropriately. We checked this during this inspection and saw that the registered manager and deputy manager had formulated a new checking and auditing system which helped ensure people’s medication was appropriately accounted for and stock was balanced. In addition, all forms of quality assurance were subject to the same auditing process. When omissions were found action plans were formulated, shared and discussed with coordinators and the members of staff responsible. The service was no longer in breach of these regulations.

Everyone we spoke with shared positive experiences of MCJA and were complimentary about the staff. People said they felt safe and trusted the service.

People’s medication was stored in their own home in line with their wishes and choices. A medication assessment was completed with each person and they were required to sign the consent agreement to enable staff to support them with medication needs. People were only supported by staff who were trained by the service and had passed competency assessments.

Staff were recruited safely. We saw that staff were only offered positions in the company once all satisfactory checks had been completed and references had been obtained.

Risk assessments were completed and reviewed every six months or when there was a change in people’s needs. Risk assessments were completed for various aspects of people’s clinical and emotional needs.

Staff were aware of their role with regards to safeguarding and raising an alert if they needed to. We saw staff were trained in this subject, and it was often a topic for discussion during team meetings. We discussed a recent safeguarding incident and saw the provider had taken appropriate action.

People received care and support by staff who were trained and had the correct skills to be able to support them. Staff completed a training programme which was aligned to national guidance, as well as completing the service’s mandatory training topics.

The service was working in accordance with the Mental Capacity Act and DoLS (Deprivation of Liberty) and associated principles. We saw that where people could consent to decisions regarding their care and support this had been well documented, and where people lacked capacity the appropriate best interest processes had been followed.

People were supported with meal provision. There was information within the staff training around providing meals and snacks including simple meal ideas and how to ensure people were eating healthy and nutritious meals.

The service liaised with other medical professionals such as GP’s or district nurses to ensure any changes or requirements to people’s care was documented.

We received positive comments about the staff and caring nature of the service in general. Staff told us they enjoyed supporting people.

Staff were able to describe how they preserved people’s dignity and respect when providing personal care.

Information contained in people’s care plans was person centred and reviewed regularly to ensure it was up to date and relevant. Information about people’s likes, dislikes and life history was recorded and reviewed. Staff we spoke with demonstrated that they knew the people they supported well and enjoyed the relationships they had built with people.

Complaints were well managed and documented in accordance with the provider’s complaints policy. The complaints policy contained contact details for the local authorities and commissioning groups. There had been no complaints since our last inspection.

Quality assurance systems were effective and measured service provision. Regular audits were taking place for different aspects of service delivery. Action plans were drawn up when areas of improvement were identified. Staff meetings took place.