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Inspection carried out on 25 October 2018

During a routine inspection

This inspection took place on 25 October 2018. This was an announced inspection as Makai Care Limited is a small domiciliary care service and we needed to be sure someone would be available at the office. At the last inspection on 4 March 2016 the service was rated Good in all domains. At this inspection we found the service remained Good in all domains. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older and younger adults. Not everyone using Makai Care Ltd receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of the inspection a registered manager was in post. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Recruitment procedures were robust and effective and helped to ensure people were provided with care by suitable staff. Staff received training to ensure they had the skills to care for people safely and effectively. People received their medicines when they required them and there was a system to manage medicines safely.

People and their relatives were happy with the service they received from Makai Care Limited. They told us they felt safe using the service. Any risks to people and staff were assessed and monitored. Staff were knowledgeable and showed awareness of how to keep people safe. They understood the policies and procedures used to safeguard people.

People’s rights in relation to making decisions was protected. People and where appropriate their relatives and other professionals had been involved in making decisions about their care. Staff understood their responsibilities in relation to gaining consent before providing support and care.

People were treated with kindness, dignity and respect and they were supported to remain as independent as they wished.

Staff were kept up to date with information concerning people or changes to their care. Staff contacted healthcare professionals to seek advice when concerns were identified regarding a person’s well-being. People were supported to have enough to eat and drink when this was part of their identified care needs.

There was an open and inclusive culture in the service. Staff felt comfortable to approach the registered manager for advice and guidance. Staff were well supported through regular meetings with their manager and training. They said they were listened to and were confident action would be taken promptly to manage any concerns raised.

The registered manager kept records relating to the management of the service which were comprehensive and appropriate.

Regular feedback was obtained from people using the service. The registered manager monitored the service through a system of audits and used these to improve the quality and safety of the service. A complaints policy was available and people were aware of it. No complaints had been received in the last year.

Further information is in the detailed findings below.

Inspection carried out on 4 March 2016

During a routine inspection

This inspection took place on 4 March 2016. This was an announced inspection as Makai Care Limited is a small domiciliary care service and we needed to be sure someone would be at the office.

At the last inspection on 27 April and 7 May 2015 we asked the provider to take action to make improvements in recruiting staff safely, ensuring decisions were made for people in their best interest and by people who had the legal right to do so, maintaining accurate records and monitoring the quality of the service. The provider sent us an action plan and told us they would meet the relevant requirements by 31 August 2015. These actions have been completed.

At the time of the inspection a registered manager was in post. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Recruitment procedures were effective and helped to ensure people were cared for by suitable staff. Staff received training to ensure they had the skills to care for people safely and effectively. People received their medicines when they required them and there was a system to manage medicines safely.

People and their relatives were happy with the service they received from Makai Care Limited. They told us they felt safe using the service. Risks to people and staff were assessed and monitored. Staff were knowledgeable and showed awareness of how to keep people safe. They understood the policies and procedures used to safeguard people.

People’s right to make decisions was protected. People and where appropriate their relatives and other professionals had been involved in making decisions about their care. Staff understood their responsibilities in relation to gaining consent before providing support and care.

People were treated with kindness, dignity and respect and they were supported to remain as independent as they wished.

Staff were kept up to date with information concerning people or changes to their care. Staff contacted healthcare professionals to seek advice when concerns were identified regarding a person’s well-being. People were supported to have enough to eat and drink when this was part of their identified care needs.

There was an open culture in the service. Staff felt comfortable to approach the registered manager for advice and guidance. Staff were well supported through regular meetings with their manager and training. They said they were listened to and were confident action would be taken promptly to manage any concerns raised.

The registered manager kept records relating to the management of the service which were fit for purpose.

Regular feedback was obtained from people using the service. The registered manager monitored the service through a system of audits and used these to improve the quality and safety of the service. A complaints policy was available and people were aware of it. No complaints had been received in the last year.

Inspection carried out on 27 April 2015 and 7 May 2015

During a routine inspection

This inspection took place on 27 April and 7 May 2015. This was an announced inspection as Makai Care Limited is a small domiciliary care service and we needed to be sure someone would be at the office.

At the time of the inspection a registered manager was in post. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were not protected from the risk of care being provided by unsuitable staff as the provider did not follow recruitment procedures thoroughly and accurate records were not kept about all aspects of the service.

The registered manager did not have a thorough knowledge of the Mental Capacity Act (2005) and was unable to say how people’s capacity was considered when making decisions about their care. However, staff understood their responsibilities in relation to gaining consent before providing support and care.

People were protected against risk of abuse by staff who had received training in safeguarding people. Staff were aware of how to keep people safe by reporting concerns promptly through procedures they understood well.

People were treated with dignity and respect and benefitted from being cared for by staff who knew them well and visited them on a regular basis. Relatives told us privacy was maintained and staff respected people’s individual preferences.

Staff felt well supported by the registered manager and said they were listened to if they raised concerns. They received training to help them carry out their role to a high standard and relatives told us they were knowledgeable about their role.

There were systems in place to manage risks to people and staff. People and their relatives were involved in decisions about their care and were asked for their views on the service.

Staff contacted healthcare professionals if there were concerns about a person’s wellbeing.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.