Archived: Mears Homecare Limited - Nottingham

Updated 9 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 4, 8 and 9 August 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that staff would be available.

The inspection team consisted of one inspector and two people working in the role of an Expert-by-Experience. These are people who have personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). 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 reviewed information the provider had sent us including statutory notifications. These are made for serious incidents which the provider must inform us about. We also contacted a local authority who funded some of the support people received for their feedback about the service.

At the provider’s office we reviewed the care records for six people who used the service. We also looked at a range of other records relating to the running of the service such as quality audits and policies and procedures. We spoke with five members of the care staff, a care coordinator, interim service manager, operations manager, regional director and the manager of the service.

After the inspection we contacted some people who used the service and some relatives or carers for their feedback about the service. We spoke with 23 people who used the service and five relatives or carers.

Updated 9 September 2016

We carried out an announced inspection of the service on 4, 8 and 9 August 2016. Mears Homecare Limited Nottingham is registered to provide personal care to people in their own homes. At the time of our inspection the service was providing the regulatory activity of personal care to 330 people.

A manager was in place and has been in post since May 2016. They were not yet registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run. An application for the manager to become registered has been received by the CQC. We will monitor the progress of the application.

Some people told us they were not satisfied with the punctuality of the staff, which could indicate sufficient staffing levels were not in place. Others told us the failure of staff to arrive on time sometimes made them feel unsafe. A new electronic monitoring system has been introduced to reduce the impact of this on people. People told us they did feel safe when the staff supported them within their homes.

The assessments of the risks people faced were not always completed in sufficient detail which increased the risk of people experiencing avoidable harm. Accidents and incidents were investigated, however the manager felt the number of reports received from staff did not reflect the size of the service. People told us their medicines were managed safely, however people’s medicines records were not always appropriately completed. A new competency assessment has been introduced by the manager to assist with reducing the number of medicines errors and improving staff performance.

Staff completed an induction prior to commencing their role and received regular supervision of their work. Staff felt supported by the manager and received regular training to enable them to support people effectively. People told us they did not always receive the same staff at their home.

The manager was aware of the principles of the Mental Capacity Act (2005); however the principles were not followed correctly when decisions were made for people.

Some people were supported with their food and drink and we found that care records did not always contain sufficient guidance on how to support people with their diet who were living with diabetes.

People’s day to day health needs were met by the staff, however the records used to support staff in doing so lacked detail and could increase the risk to people’s health. People told us where needed, staff supported them with contacting their GP or other healthcare professional.

People told us they thought the staff were kind and caring, treated them with respect and dignity and listened to and acted on their wishes. People felt able to contribute to decisions about their care. People’s independence was supported.

Staff discussed people’s needs with them prior to them starting to use the service. People’s care records had elements of person centred care. This included daily routines for staff to support people in the way they wanted them to. People’s care needs were reviewed.

People were provided with the information they needed if they wished to make a complaint. Some people felt their complaints were handled appropriately, however others did not. We saw a high volume of complaints were received in a two month period, April to May 2016 with regards to staff punctuality. This had improved in June and July 2016. The majority of complaints were responded to in line with the provider’s complaints policy, but we saw one had not been.

There had been a high turnover of managers at the service in the past 12 months. The current manager told us they wished to remain at the service and explained the processes they had in place to improve the service. Some people told us they did not know who the manager was. People told us they had been asked for their views on the quality of the service provided, but some felt this would result in little improvement.

The manager was respected by their staffing team and they understood their responsibility to ensure the CQC were notified of incidents that had occurred.