Background to this inspection
Updated
13 June 2017
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.
The inspection took place over two days on 17 and 18 May 2017. The inspection was announced which means that we gave the provider 48 hours’ notice of the inspection to ensure key staff were available to speak with us.
The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. On the first day, we visited the registered office and reviewed records and talked with the head of operations and other senior staff. On the second day we visited people who received support from the service in their own homes and spoke with two of them. We also spoke with people and staff on the telephone. Our expert by experience telephoned people and their relatives to gain their views about the care and support provided by the service.
Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission (CQC). A notification is used by registered managers to tell us about important issues and events which have happened within the service. 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, such as what the service does well and improvements they plan to make. We used this information to help us decide what areas to focus on during our inspection.
Many of the people using the service were unable to give us detailed feedback about the quality of their care and so we spoke with their family members. Overall, we spoke with five people and six relatives. We also spoke with the head of operations and 13 other staff including front line managers, senior support workers and support workers. We reviewed the care records of three people in detail. We also viewed other records relating the management of the service such as staff files, rotas, audits and policies and procedures. Following the inspection, we sought feedback from five health and social professionals about the quality of care people received.
This is the first inspection of this service since it registered with the Care Quality Commission in June 2016.
Updated
13 June 2017
The inspection took place over two days on 17 and 18 May 2017. The inspection was announced which means that we gave the provider 48 hours’ notice of the inspection to ensure key staff were available to speak with us.
MacIntyre Care is a national charity providing support to people with learning disabilities. This service provided a personal care service to 25 people from a registered office in Totton Southampton. All of the people being supported by the service lived in their own home. Some people lived alone, whilst others lived in shared houses or supported living settings across Hampshire. The levels of support provided varied. Some received just a few hours support from an outreach service, whilst others received 24 hour care and had more complex health and social care needs.
The service did not have a registered manager. The previous registered manager had left the service in February 2017. A new manager had been appointed and was due to start in June 2017. 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 and associated Regulations about how the service is run. When in post the registered manager was supported by a number of front line managers, or heads of service, who had delegated day to day responsibility for managing the delivery of care within people’s homes.
Recruitment practices needed to be more robust to ensure that all of the relevant checks were completed. Full employment histories had not been obtained for two staff members. This information has now been obtained. There were sufficient numbers of staff to meet people’s needs.
Medicines were managed safely. Systems were in place to respond to and learn from medicines errors and medicines audits were undertaken to ensure medicines were being managed safely.
People told us they felt safe and there were systems and processes in place to protect them from harm. Care plans contained risk assessments and risk management plans.
Staff received a comprehensive induction which involved learning about the values of the service, the needs of people using the service and key policies and procedures. A comprehensive training programme was available and plans were in place to ensure that all staff refreshed their training in a timely manner.
Where necessary staff had undertaken mental capacity assessments to determine whether people could consent to the care and support being provided. Staff used a restrictions checklist to identify whether the care arrangements in place might in some cases amount to a deprivation of people’s liberty in order to protect them from harm. Where this was the case, action had been taken to notify the Local Authority so that they could seek the relevant authorisations from the Court of Protection.
People were supported to have enough to eat and drink and their care plans included information about their dietary needs and risks in relation to nutrition and hydration.
Where necessary staff had worked effectively with a range of other healthcare professionals to help ensure that people’s health care needs were met.
People told us that the staff supporting them were kind and caring and helped them to live a busy and active life. Staff had a good knowledge and understanding of the people they were supporting. Staff were able to tell us about people’s likes and dislikes which demonstrated they knew them well.
Care records were person centred and helped staff provide care which was in keeping with people’s needs and wishes.
People were provided with opportunities to give feedback about the care and support they received. Complaints policies and procedures were in place.
Systems were in place to assess and monitor the quality and safety of the service and to ensure people were receiving the best possible support.