26 June 2018
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 23 May 2018 and was announced. The inspection was completed by one inspector.
We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.
Inspection site visit activity started on 23 May 2018 and ended on 29 May 2018. It included assessing records at the providers office and telephone calls and interviews with people who used the service, relatives and care workers. We visited the office location on 23 May 2018 to see the manager and office staff; and to review care records and policies and procedures.
Before the inspection the provider completed 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 also reviewed the information we held about the service, such as notifications we had received from the registered provider. A notification is information about important events which the service is required to send us by law. We planned the inspection using this information.
At this inspection we spoke with three people who used the service, one relative, two care workers, one care coordinator, the registered manager, the training and recruitment manager and the nominated individual.
We also spent time looking at records, which included the care records for four people. We looked at the recruitment, supervision and appraisal records of four members of staff, a full staff training matrix and other records relating to the management of the agency.
26 June 2018
This inspection took place on 23 May 2018 and was announced. During our last inspection on 24 August 2016 we found the provider was in breach with Regulation 17 Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2010. The provider failed to maintain records in relation to persons employed in the carrying on of the regulated activity. The provider was also in breach with Regulation 19 HSCA 2008 (Regulated Activities) Regulations 2010. We found the provider failed to operate an effective recruitment process to ensure that staff were of good character, had the qualifications, skills and experience which was necessary for the work performed by them.
The provider sent us an action plan following our inspection in August 2016 telling us that they had taken the appropriate actions to address the breaches and that they were no longer in breach with the regulations.
We found during this inspection that the provider had undertaken appropriate checks of new prospective staff employed to ensure they were of good character, had the qualifications, skills and experience required to work and support people who used the service.
Mercyland Care Limited is a domiciliary care agency. It provides personal care to ten people living in their own houses and flats in the community. It provides a service to older adults some of them may have dementia. Not everyone using Mercyland Care Limited 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. Since our last inspection the provider has moved the location to a new office building, the registered manager told us that this was to reduce costs and due to issues, they had with the previous landlord.
A manager was 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.
We found that appropriate systems, processes and practices were adhered to ensure people who used the service were safeguarded from abuse. Risk to people was assessed and management plans were put into place to ensure people were not at risk of receiving unsafe personal care. People told us that the agency provided sufficient staff suitable to meet their needs. Where people received support with medicines appropriate systems were followed to ensure the proper and safe use of medicines. Staff followed appropriate infection control procedures to minimise the risk of spreading infections. Since our last inspection, Mercyland Care Limited did not have to deal with any incidents or accidents in relation to carrying out the regulated activity, but we were told by the registered manager that any accidents and incidents would be discussed during care workers meetings.
New prospective people who used the service had been assessed to ensure the service was able to meet people’s needs. Care workers had access to a wide range of training and were supported to develop their skills and knowledge to deliver effective care. Where required people’s dietary needs were documented in their care plans and appropriate care was provided to people who used the service. Care workers would contact emergency services if required. People who used the service had a designated representative if this was required to ensure consent was sought in line with legislation and guidance.
People who used the service told us they were treated with kindness and respect. We saw that people and their relatives could express their views and were actively involved in making decisions in relation to their care. Care workers told us that they ensured people’s privacy, dignity and independence was respected and promoted.
People received personalised care that was discussed and planned with them or their representative. People who used the service were encouraged to raise concerns and complaints, which was used to improve the quality of service.
People who used the service and care workers told us that the registered manager was approachable and listened to what they had to say. They described the organisation’s culture as open, transparent and inclusive. The provider had an effective quality assurance system in place. People who used the service and care workers were regularly engaged to comment on the service provided to drive improvement and promote good quality care.