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Inspection Summary


Overall summary & rating

Good

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 t

Inspection areas

Safe

Good

Updated 18 November 2017

The service was safe.

Medication was managed and administered safely.

Staff were recruited safely following robust recruitment checks.

Risks to people�s health, safety, and emotional well-being were assessed and regularly updated and reviewed.

Effective

Good

Updated 18 November 2017

The service was effective.

Staff engaged on a programme of training put into place by the service and were required to complete a comprehensive induction.

The service following the Mental Capacity Act and associated principles with regards to best interests� decision processes and obtaining consent.

People were supported to prepare meals in accordance with their own preferences and staff were aware of people who had special dietary needs.

Caring

Good

Updated 18 November 2017

The service was caring.

People told us they liked the staff and were complimentary about the staff and the service in general.

Staff were able to describe how they protected peoples dignity and respected their choices.

Staff were trained to support people and their families at the end of their life.

Responsive

Good

Updated 18 November 2017

The service was responsive.

People were receiving care and support which was personalised and met their needs. Information relating to people�s backgrounds, likes and dislikes was also recorded in their care plans.

There was a complaints process in place which was discussed with people at the time they started to use the service. There had been no complaints since our last inspection.

Well-led

Good

Updated 18 November 2017

The service was well-led.

There was a registered manager in post who was well known amongst the staff and people who used the service.

There were audits in place which addressed any shortfalls in service provision by the formulation of detail action plans which were delegated out to the service coordinators for completion.

The service regularly sought feedback from people and their families regarding the delivery of care.