Background to this inspection
Updated
21 February 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 29 and 30 January 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit. This was because it is a domiciliary care agency run from an office. We needed to make sure that appropriate staff and managers would be available to assist us with our inspection.
The inspection was carried out by two inspectors who visited the office location on both days of the inspection. Two experts by experience who made telephone calls to people and their relatives prior to the visit to the office. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care services for example a domiciliary care service.
Prior to this inspection we reviewed the Provider Information Record (PIR). The PIR is a form that the provider submits to the Commission which gives us key information about the service, what it does well and what improvements they plan to make. We reviewed the previous inspection reports and other information we held about the service such as notifications they had sent to us. We contacted other agencies who sub contracted work to the agency to obtain their views about the care provided.
During the inspection we spoke with the registered manager, a care coordinator, a team leader and eight care staff. We visited four people in their own homes on day two of the inspection and spoke with nineteen people and seven relatives prior to the inspection. We spoke with a further two relatives after the inspection.
We looked at a number of records relating to individuals’ care and the running of the service. These included seventeen care plans, medicine records for eight people, seven staff recruitment and supervision files, accident/incident reports, audits, complaint’s log, staff schedules and team meeting minutes.
We asked the provider to send further documents and policies after the inspection. The provider sent us documents which we reviewed and used as additional evidence.
Updated
21 February 2018
The inspection took place on the 29 and 30 January 2018 and was announced. The location was previously inspected in June 2016. It was not in breach of any regulations of the Health and Social Care Act 2008 at that time, however they received an overall requires improvement rating. This was a comprehensive inspection to review the progress made and rating since the previous inspection.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults. At the time of the inspection they were providing a care package to 180 people whose contract of care was sub- contracted to them from another two agencies.
Not everyone using Mayfair 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.
The agency 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 2008 and associated Regulations about how the service is run.
At the previous inspection in June 2016 the service was rated as requires improvement in all domains, with an overall requires improvement rating. At this inspection we found the service provided safe, effective, caring and responsive care. The service had a committed registered manager who had made the improvements to the service. However, the lack of an electronic logging in and out system meant there was a delay in auditing if all of the care calls had been provided which has resulted in a requires improvement rating for well- led.
Staff schedules were planned in geographical areas to cut down on travel time between calls and in an attempt to reduce delays between calls. The registered manager and staff from the agency felt confident no calls were missed. However, records were not always completed to support this and some people told us they had experienced missed calls.
People were asked for feedback on the service to improve practice. The registered manager and the provider audited the service to satisfy themselves the service was running effectively. However, the task of manually auditing communication sheets for the previous month meant that gaps in care calls were not highlighted and brought to their attention in a timely manner to ensure people got the care calls they required.
Some people were happy with the care provided. They had positive relationships with staff and described staff as kind, caring, excellent, helpful and accommodating. One person described staff as like friends to them. Other people told us that the times and reliability of the calls could improve.
Systems were in place to safeguard people. Risks to people were identified and managed. People were assessed prior to the package of care commencing. They had support plans in place which outlined the support required at each call. The support plans were updated and reviewed in response to people’s changing needs.
Medicines were safely managed with people supported and enabled to self-medicate where possible. Staff were clear of their responsibilities in relation to medicine administration.
People’s privacy and dignity was promoted. Staff were respectful of the person’s home and their environment.
Staff were suitably recruited, inducted, trained, supervised and supported. This enabled them to have the right skills and training to support people effectively. Staff felt they worked well together as a team to ensure people got their required care calls.
People and their relatives knew how to raise concerns. They confirmed the registered manager was responsive to issues raised by them to offer a resolution.
The registered manager was a positive role model to staff. They provided hands on support when required. They addressed poor practice and was committed to providing the best care to people. They were instrumental in bringing about the improvements to the service but also recognised the challenges that they faced in managing a domiciliary care service.