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Inspection carried out on 26 November 2019

During a routine inspection

About the service

MCA Care Homes is a residential care home providing personal care and support for up to three people with learning disabilities. At the time of the inspection one person was using the service. The service is also used by a few people on a regular respite basis.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Relatives spoke positively or the caring and person-centred nature of the service. They told us people liked staying at MCA Care Homes.

Risks associated with people’s health and care needs had been assessed and guidance provided to care staff on how minimise risks to keep people safe from harm.

There was enough staff available to support people safely. Recruitment processes enabled the provider to only recruit those staff assessed as safe to work with vulnerable adults.

The person using the service at the time of inspection did not require support with medicines. However, procedures were in place if people needed support with medicines.

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.

Care plans were detailed and listed people’s support needs and how staff were to support people with their identified needs.

Management oversight processes in place enabled the service and the provider to monitor, and where required, improve the quality of care people received.

The service applied the principles and values the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The last rating for this service was good (published 26 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 25 April 2017

During a routine inspection

We undertook an unannounced inspection on 25 April 2017. M.C.A Care Homes provides care and support for a maximum of three people with learning disabilities. At the time of the inspection there were two people living at the home.

At the last inspection, the service was rated as Good.

At this inspection we found the service remained as Good.

The service had a registered manager. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Risks had been identified and assessed that provided information on how to mitigate risks to keep people safe.

Medicines were being managed safely. Medicines audits and staff competencies had not taken place. The registered manager informed this will be introduced and sent us evidence after the inspection which confirmed that audits would be carried out regularly.

Staff received regular supervision and support to carry out their roles. Mandatory training had been provided to staff in safeguarding, infection control and first aid. Specific training had not been provided to staff to support people with learning disabilities and autism. After the inspection the registered manager sent evidence confirming that training had been booked in these areas.

Staff sought people's consent to the care and support they provided. People's rights were protected under the Mental Capacity Act 2005. Deprivation of Liberty safeguarding applications had been made for people that, due to their own safety, required supervision when going outside.

There was a menu for meal times, which was different every day. Staff and relatives we spoke to told us that people enjoyed the meals.

People were able to access healthcare services and attend routine medical appointments and health monitoring with staff support.

Staff had positive, caring relationships with the people who lived at the home.

People were treated in a respectful and dignified manner by staff who understood the need to protect people's human rights.

Activities were being carried out with people.

People were receiving person centred care. Care plans were personalised and person centred.

Staff told us they felt supported by the registered manager.

Spot checks were being carried out to observe staff performance. Surveys were carried out to obtain feedback, which was analysed for continuous improvements.

Inspection carried out on 14 & 15 April 2015

During a routine inspection

We undertook this unannounced inspection on 14 and 15 April 2015 of M.C.A. Care Homes to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. M.C.A. Care Homes provides care and accommodation for a maximum of three people. People living in the home have a learning disability and some of them stay only for short periods of respite care. At this inspection there were three people living in the home. The provider met all the standards we inspected against at our last inspection on 30 May 2014.

The home had a registered manager. 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 of the Health and Social Care Act and associated Regulations about how the service is run.

On both days of the inspection staff were welcoming and people in the home appeared settled and well cared for. People living in the home had learning disabilities and we were unable to obtain specific feedback from them. However, the feedback received from them via nods and gestures indicated that they were satisfied with the care provided.

Three social care professionals who provided us with feedback indicated that their clients were well cared for and they were happy with the management of the home.

The staffing levels were adequate. We saw staff going about their duties in a calm and orderly manner. They were friendly and interacted well with people. Staff were able to get the co-operation of people and people responded well to staff.

People had been carefully assessed and care plans were prepared with the involvement of people and their representatives. Their physical and mental health needs were closely monitored. There were reviews of people’s health and a record of appointments with health and social care professionals. There were suitable arrangements for the recording of medicines received, storage, administration and disposal of medicines in the home.

Staff had been carefully recruited and provided with training to enable them to care effectively for people. Staff demonstrated a good understanding of the needs of people with learning difficulties.

The home had a safeguarding adults and whistleblowing policy. Staff had received training and knew how to recognise and report any concerns or allegations of abuse.

Staff had assessed people’s preferences prior to their admission and arrangements were in place to ensure that these were responded to. People could participate in activities they liked and go on outings. There were suitable arrangements for the provision of food to ensure that people’s dietary needs were met.

The home had arrangements for quality assurance. This included giving frequent updates to relatives of people and receiving feedback from them. Regular audits and checks had been carried out by the registered manager and the nominated individual. Professionals who provided us with feedback stated that they were satisfied with the quality of care provided and there were no concerns regarding communication.

We found the premises were clean and tidy. The home had an Infection control policy and measures were in place for infection control. There was a record of essential inspections and maintenance carried out.

Inspection carried out on 29, 30 May 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

At the time of this inspection there were three people living in the home. People who used the service had learning difficulties and were there for respite care. Two of them were able to express their views via short sentences and with facial expressions. The third person had gone out to a day centre.

We observed the care provided and the interaction between staff and people who used the service. We spoke with three care staff, the registered provider and the registered manager. We also spoke with two relatives of people who used the service.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People indicated to us that they were well treated by staff. One of them nodded their head and the other smiled when we asked them if they were well treated. The two relatives we spoke with were confident that people were safe in the home. The service had a safeguarding policy and procedure. Staff had been provided with safeguarding training. They were aware of action to take in response to safeguarding incidents or allegations. The home had been kept clean and tidy. Risk assessments of the premises had been carried out. Toxic cleaning substances were kept locked and out of reach of people when not in use.

Is the service effective?

Feedback from relatives and people who used the service indicated that the service was effective and relatives thought highly of the home. One relative stated, �My relative stayed in the home for several days. The staff are very good to my relative. We have had no problems.� People�s care needs had been assessed before they arrived at the home and arrangements had been made to ensure that they were able to continue participating in activities they liked. The care plans were up to date and addressed the important aspects of the person�s care including their likes and dislikes of people. The arrangements for the administration of medication were satisfactory and relatives informed us that people had been given their medication as prescribed.

Is the service caring?

Relatives informed us that staff took good care of people. One relative said, "My relative is well cared for and happy in the home. My relative refer to the staff as friends." Another relative said, �The staff know what they are doing and I have confidence in them.� Staff were aware that all people should be treated with respect and dignity. They were knowledgeable regarding the specific care needs of people. Care plans were up to date and relatives informed us that they had been consulted regarding the individual needs of people. Staff had an understanding of people�s cultural and religious needs and where appropriate, arrangements had been made to meet these needs. We noted that staff spoke in a gentle and friendly manner towards people.

Is the service responsive?

Relatives told us that staff were aware of the preferences and needs of people in areas such as meals and activities had been responded to. One relative stated, "The staff are capable and they can respond well and appropriately in an emergency.� Staff we spoke with were able to tell us how they would respond if people experienced difficulties such as seizures or behavioural problems. We observed that staff were attentive towards people and when people needed assistance, staff responded promptly.

Is the service well-led?

The registered manager was knowledgeable regarding his role and responsibilities. There were arrangements for monitoring the quality of care provided. Spot checks had been carried out by the manager. Regular checks on medication arrangements and care documentation had been carried out by the registered provider.

Staff meetings had been held and the minutes of these meetings indicated that staff had been updated regarding the management of the home and the care of people. Staff we spoke with informed us that they had been provided with appropriate support to enable them to take good care of people. Essential training had been provided and staff were knowledgeable regarding their roles and responsibilities.

Inspection carried out on 6 September 2013

During a routine inspection

We were not able to get the direct opinions of people who use the service, however we spent time observing the care and support provided to people. We saw that staff knew how to communicate with people and understood their needs. We noticed that the way that staff interacted with people had a positive effect on their well-being. We also spoke with a relative who told us, �it�s a brilliant service. I�d recommend them.� We found that care was planned and delivered in a way that was intended to ensure people's safety and welfare and meet their individual needs.

We checked all areas of the premises and found no concerns in terms of its safety and suitability. The environment was well maintained, clean, and felt homely. People were protected from the risk of infection because appropriate guidance had been followed. We found that staff knew people�s individual nutritional needs and we saw that these were addressed.

There was an effective system to regularly assess and monitor the quality of service that people received. �If there�s any issues, they contact me, and if I�ve any concerns they sort it out,� a relative said. The manager told us he kept in regular contact with people�s relatives. We were told and shown examples of how comments made about aspects of the service had results in alterations to how the service was provided to individuals.

During a check to make sure that the improvements required had been made

People who use services could be confident that important events that affect their welfare, health and safety would be reported to the Care Quality Commission so that, where needed, action could be taken. This was because the provider had made improvements to their notification systems.

Inspection carried out on 6 November 2012

During a routine inspection

We were not able to get the direct opinions of people who use the service, however we spent time observing the care and support provided to people. We observed that people were involved and consulted about decisions affecting their care. Staff knew how to communicate with people and understood their needs. Staff spoke with people in an appropriate manner, and respected their decisions. Staff knew how to support people to meet their needs.

We also spoke with a relative of someone who uses the service, who told us, �It�s a brilliant service.�

Inspection carried out on 26 July 2011

During a routine inspection

Due to communication difficulties of the people who were using this service during our visit, we interpreted their experiences of the service though our observations. We also spoke to some representatives of people who use services after our visit.

People told us that the service meets the needs of those that use it. Comments included, �I was very impressed when he came back and was clean and happy.�

People spoke positively about the staff at the service, telling us for instance that, �Staff asked the right questions and staff treated him well.�

People told us that the service keeps them informed. Representatives were contacted for advice on how to meet people�s needs, which was appreciated.

People told us that there is enough to do at the service. Comments included that the person using services �was not bored there.� We watched services being provided and saw people using it were comfortable there, with some people smiling and laughing a lot in their interactions with staff. Staff were respectful, attentive and friendly to people, and encouraged independence and skills development.

In summary, people were generally satisfied with the standard of care and support provided by the service. As one person put it, �It�s all perfect.�

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