17 January 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 4 December 2017 and was unannounced.
Inspection site visit activity started on 4 December 2017 and finished on 14 December 2017. It included sampling people’s care records, talking with people and their relatives about the care provided and finding out the views of other health and social care professionals about the quality of the service. We visited the office location on 4 November 2017 to see the registered manager and office staff; and to review care records and policies and procedures. We spoke with people, their relatives and additional staff up to 14 November 2017, to find out what they thought about the care provided.
The inspection was carried out by one inspector.
We looked at the feedback provided to us by people who used the service. We sought information about the service provided to people from the local authority. The local authority has responsibility for funding people who use domiciliary care services and monitoring their safety and quality. This included recent monitoring visits made by the local authority. This information provided an insight into some aspects of the service where improvements were required and identified concerns. We used this information when planning and conducting this inspection to gain an insight into whether the provider had made improvements.
We used information the provider sent us in the Provider Information Return [PIR]. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We looked at information we held about the provider and the service. This included notifications which are reportable events which happened at the service which the provider is required to tell us about. We used this information to help plan this inspection.
We spoke five people who use the service and four relatives by telephone. We talked with the registered manager, one staff member and the office administrator. In addition, we spoke with two staff by telephone.
We looked at a range of documents and written records. These included sampling six people's care records, four staff recruitment files and key policies and procedures, such as how people’s rights were promoted and how the staff would respond to any complaints made.
We also looked at information about how the registered manager monitored the quality of the service provided and the actions they took to develop the service further. This included surveys completed by people who used the service.
17 January 2018
This inspection took place between 4 December 2017 and 14 December 2017. This was the first inspection of the service and it was unannounced. MCare24 Limited is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of our inspection 11 people were provided with personal care.
A registered manager who was also the provider was in post at the time of our inspection. 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 was run.
People felt safe with all of the staff who provided care and supported them in their homes. There were arrangements in place to make sure there were sufficient staff available to meet people’s care calls and who understood the need to protect people from the risk of harm and abuse The registered manager had taken measures to reduce risks to people’s safety. Staff were trained in how to recognise abuse and understood the action they should take if they had any concerns people were at risk of harm. The registered manager checked staff’s suitability to deliver personal care in people’s own homes during the recruitment process.
People’s care plans included risk assessments for their health and wellbeing and explained the actions staff should take to reduce the identified risks. Staff understood people’s needs and abilities by working alongside experienced staff when they started working at the service, speaking with people about their needs and reading care plans.
The registered manager had developed a system to record accidents and incidents and to reduce any reoccurrence. Where people needed support to take their medicines they were assisted by staff who had been trained to do so. The registered manager had procedures in place to check people received their medicines as prescribed, in accordance with their health needs.
Staff received training and support to meet people’s needs effectively. Staff had opportunities to reflect on and improve their practice for the benefit of providing people with care and support to effectively meet their care needs. Staff recognised how their training had provided the knowledge of how to reduce the risks of infections spreading and had been provided with the right equipment to assist them in their daily care work.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. This included involving people in decisions about their day to day care. Staff knew which people may need help to make some key decisions about their lives and understood what action to take so people received the support they needed in these circumstances
Where people required support from staff with their meals and drinks this was provided. People were happy with how they could rely on staff if they needed assistance in accessing health care services when they needed them to get the best outcomes for people’s health and well-being.
People's care records were personalised and contained information about people's preferred daily routines. People who used the service and relatives were involved in the planning and review of their care so any changes could be responded to. The registered manager regularly delivered care and support, so they maintained an on-going relationship with each person.
People told us the staff who provided care and supported them in their homes were kind and respected their privacy, dignity and independence and said staff felt like their friends. People knew any concerns would be listened to and action taken to resolve any issues.
People were encouraged to share their opinions about the quality of the services provided during visits by the registered manager and at regular reviews of their care plans and through formal surveys.
The registered manager and staff team shared common values about the aims and objectives of the services they provided to people in their homes. People were supported and encouraged to live as independently as possible, according to their needs and abilities.
The registered manager had a candid approach to using the learning from external professionals and resources on the computer to aid the development of providing people with a home care service. The registered manager’s quality checking arrangements were continuing to be developed and included regular checks of people’s care plans and staff’s practice. When issues were identified action was taken to continually improve, develop and sustain the quality of the services provided to people in their homes.