Archived: Medacs Healthcare Stafford

We last inspected this service in June 2016, at which time we found that improvements were needed in relation to how the service was monitoring the quality of care being delivered.

At this inspection we found that the service was not being effectively managed and that the required improvements had not been made or effectively implemented. We also identified further areas that required improvements to ensure people received care that was safe, effective, responsive and well-led. We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. One of these was an on-going breach in relation to how the service was being managed. You can see what action we told the provider to take at the back of the full version of the report.

The service is registered to provide personal to people in their own homes. At the time of our inspection 38 people were using the service. There were 22 members of staff working at the service.

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 requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We found that staff felt unsupported, that they were unclear about the values and vision of the organisation and that they had little confidence in the registered manager. We found that people using the service were not always listened to and that complaints and concerns had not always been adequately addressed to people's satisfaction.

Risks to people’s health, safety and wellbeing were not being identified, managed and reviewed and medicines were not managed safely.

People's care needs were not regularly reviewed. People’s care plans were not accurate and up to date which meant staff didn’t always have the information they needed to provide safe and consistent care.

The registered manager did not understand the requirements of the Mental Capacity Act 2005 and staff did not always understand what was meant by mental capacity, despite some people using the service having conditions which may have affected their mental capacity.

Staff training was not being monitored by the registered manager to ensure the quality of care being delivered.

Safeguarding incidents were recorded and the appropriate agencies were notified, however, the service had not always responded to protect vulnerable people from the possible risk of abuse.

People were treated with respect and staff were able to describe how they delivered care to meet people individual needs. However, care was not being planned to ensure people received individualised care that promoted their independence.

Effective systems were not in place to ensure concerns about the quality of care were investigated and managed to improve people’s care experiences.

There were insufficient staff working at the service at the time of inspection.

Staff had been safely recruited and notifications had been made when incidents had been identified as needing to be notified.

The service had a registered manager. However, the person currently named on our register was not the same person who was now managing the service. 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.

The provider had some systems in place to monitor the quality of the service, however improvements were required to ensure that all areas of care delivery were audited to identify any areas of concerns or weakness, so that people benefitted for a safe, reliable service.

People were supported in their own homes and told us they felt safe and comfortable with the service provided.

Risks to people’s safety and welfare were not always identified or action taken to reduce the risk. Care and support plans were basic and did not always reflect the care and support being provided by carers.

Information was not always available for carers when people needed support with medicines for example creams and lotions.

Systems were in place to ensure that people who used the service were protected from the risk of abuse. Staff had received training in safeguarding adults from abuse and were aware of the procedures to follow if they suspected that someone was at risk of harm.

The provider followed the principles of the Mental Capacity Act 2005 (MCA 2005) and ensured that people consented to or were supported to consent to their care and support.

People received care from carers who were supported, trained and supervised to fulfil their role effectively.

People were supported to choose what they wished to eat and drink and if they became unwell carers responded and gained the appropriate healthcare support.

People were treated with dignity and their privacy was respected. People were encouraged to be as independent as they were able to be.

There was a complaints procedure and people knew how to use it. The provider took the appropriate action when complaints were raised.