Mofor Solutions Limited

Mofor Solutions is a is a domiciliary care agency and supported living service providing personal care support to people in their own homes. At the time of our inspection, staff were providing personal care to 15 people. This included older people (aged over 65), some of which, were living with dementia, mental health conditions, physical disabilities, learning disabilities or autistic spectrum disorder.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

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.

The service applied 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.

People felt safe with the care staff who supported them, and risks associated with people’s care had been assessed. Care plans confirmed the support people required in accordance with what had been agreed. However, care records were not always fully detailed to support staff in ensuring risks were safely managed. Staff followed safeguarding procedures if they identified any concerns to ensure people were kept safe.

People told us they received their medicines when they needed them.

People were treated with dignity, respect and kindness. Staff knew people well, so they could provide personalised care. People’s preferences for care were recorded in their care plans to ensure they received care and support in accordance with their wishes. People confirmed they received the support as agreed and spoke positively of the caring approach of staff.

Staff recruitment records did not confirm all checks had been completed in accordance with the providers recruitment procedure to demonstrate staff had been recruited safely. There were sufficient numbers of suitably trained staff to support people’s care needs and people told us staff took the time people needed to be supported with their care.

Staff understood their responsibilities to maintain good infection control practice to prevent the spread of infection and people confirmed staff followed good practice when supporting them.

The registered manager completed a range of audit checks to make sure the service ran effectively. These checks had not consistently identified areas needing improvement that we had found such as those linked to care plans, recruitment, medicines and risk management. The registered manager arranged competency checks of staff regularly to make sure they continued to support people safely and appropriately.

Staff worked with other professionals so that people received support when needed. Staff supported people to make contact with health care professionals if required.

People knew how to raise any concerns with the agency if needed and there were quality monitoring systems to enable the provider to have oversight of the service. The registered manager told us of planned changes to ensure going forward areas for improvement were identified more effectively to drive improvement of the service.

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 5 October 2016).

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.

We inspected this service on 15 September 2016. The inspection visit was announced. We told the provider 48 hours before the visit we were coming so they could arrange to be available to talk with us about the service.

This service was last inspected on 16 May 2014 and we found the provider was compliant with the essential standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

There was a registered manager 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. The registered manager was also the provider of the service.

People felt safe with the staff that provided their care and staff understood their responsibility to protect people from abuse and keep people safe. Checks were carried out prior to care staff starting work to ensure their suitability to work with people who used the service. Staff were trained to give medicines safely and there was a robust system for checking people had received their medicines as prescribed.

Risks to people’s health and wellbeing were identified at an initial assessment of care, and care plans included actions staff should take to minimise the risks. Staff understood people’s needs and abilities because they visited the same people regularly and had time to read their care plans. People told us staff were kind and respected their privacy, dignity and independence.

People were involved in planning their care and care plans provided detailed guidance for staff about how people would like their care delivered. Plans were regularly reviewed to make sure people continued to have the support they needed.

There were enough staff to deliver the care and support people required. Staff received the training and support they needed to meet people’s needs effectively. New staff shadowed experienced staff so they could get to know people before working with them independently.

The managers understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). People made their own decisions about their care and had given agreement for the care to be provided. Staff respected people’s decisions and gained people’s consent before they provided personal care.

People and staff were confident they could raise any concerns or issues with the management team, knowing they would be listened to and acted on.

The management team checked people received the care they needed by monitoring the time staff arrived for scheduled calls, reviewing daily records, and through feedback from people.

The provider’s quality monitoring system included asking people for their views about the quality of the service through telephone conversations, visits to review their care and questionnaires. There was a programme of other checks and audits which the provider used to monitor and improve the service.

During our inspection we looked to see whether we could answer five key questions: Is the service safe, effective, caring, responsive and well led? Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

Recruitment procedures were rigorous and thorough. We looked to see whether there were the right levels of staff working at the service. We looked at staff numbers and staff training. These showed there were enough suitably qualified and experienced staff to meet people's needs.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistle-blowing and investigations. This reduced the risks to people and helped the service to improve.

We checked whether people's medicines were being managed safely. We found people's medication was being appropriately administered and safely managed.

We found staff could raise issues of concern with the service. They were told about the whistle-blowing policy and procedures when they started work at Mofor Solutions. The whistle-blowing procedure ensured staff were protected during any subsequent investigation.

Is the service effective?

People's health and care needs were assessed before they used the service to determine their needs and make sure the service could meet them effectively.

We saw arrangements were in place for care plans to be reviewed regularly to make sure information about people's care and support needs remained accurate. However, we found that care plans did not always contain enough detailed information with regard to the management of risks to ensure the safety of people who used the service.

Is the service caring?

People and relatives we spoke with were generally positive about the care provided by staff. One person told us, 'I'm happy with them, they look after me."

One person we spoke with told us they had not felt well cared for by one person that visited them. This was because they felt it was difficult to communicate with the person due to their poor English language skills. Other people we spoke with told us they felt safe using the service and with the staff that visited them.

Is the service responsive?

People who used the service, their relatives and other professionals were asked to comment on the service provided so they could gather feedback on how they could improve.

The Service User Guide (SUG) given to all of the people who used the service contained information about how to contact the office, and how people could give feedback about their care.

We reviewed the compliments and complaint information held in the office. We saw that written complaints were investigated and responded to in a timely way.

Is the service well-led?

There were processes and systems in place to monitor the service provided. The provider used the information gathered through these processes to assess and improve the quality of service for people.

Staff understood their roles and received support and training on a regular basis to ensure that they were competent to provide care and support to the required standard.

'The service is very good, we have two lovely men that come in' we couldn't wish for two better carers, they make my husband giggle and always cheer him up'.

'This is the first time I've had to have care' two people come each time'they're very respectful and they take their time with him'.

'I'm very satisfied with the care... the carers are very good, they all wear uniforms, are clean and know what they are doing...she has developed a good relationship with them'.

We looked at a care records. We were satisfied the organisation worked with people to understand what their care needs were and put care packages in place that people agreed to, and reflected their wants and needs.

We looked at the safety of the administration of medicines. We were satisfied that the service had improved its practice in this area. Written medication records now clearly demonstrated the medication prescribed and staff's responsibility in administering it.

We looked at staff support. We were satisfied that staff received the support they needed to undertake their roles safely.

We looked at how the service gets feedback from staff and people who use it. We saw that systems were in place to get regular feedback from people using the service.

People we spoke with were generally pleased with the service provided to them. People told us, 'It's very good really', 'I'm mega confident with Moforcare', and 'Staff are wonderful'. There were some concerns voiced about the length of time some people had to wait for calls.

We checked staff recruitment processes and were satisfied that the relevant checks were made to keep people safe.

We looked at staff training. The majority of staff working at Mofor Solutions had previous experience of working in care and had received training in previous organisations. We were not satisfied that there was sufficient training for staff at Mofor to support them in the work they did. The organisation had recognised this and was putting systems in place to rectify it.

We looked at care records, medication records and staff records. We were not satisfied that the records provided sufficient information to protect people against the risks of unsafe care. We were made aware this had been identified as an area of concern by the organisation, and action plans were in place to improve this.