Archived: Meridian Health and Social Care - Leicester

Sevacare – Leicester is a domiciliary care agency which provides personal care to people living in their own homes. The Care Quality Commission (CQC) regulates the care provided, and this was looked at during this inspection. The last inspection rated the service as requires improvement. We received an action plan to deal with the issues raised in this inspection. Improvements in the service have been made and it is now rated as good.

This was a comprehensive inspection. The inspection took place on 9 and 10 May 2018. The inspection was announced because we wanted to make sure that the registered manager was available to conduct the inspection. The registered manager told us that 70 people were receiving a personal care service from the agency.

A registered manager was in post. This is a condition of the registration of 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 and associated Regulations about how the service is run.

Risk assessments and staff practice were in place to protect people from risks to their health and welfare.

Staff recruitment checks were carried out to protect people from receiving personal care from unsuitable staff.

People told us they thought the service ensured safe personal care was provided by staff. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area but had not been comprehensively aware of how to report to other relevant agencies if necessary.

Policies set out that when a safeguarding incident occurred management needed to take action, though it was unclear that all abuse, or allegations of abuse, would be referred to the relevant safeguarding agency. The registered manager was aware these incidents, if they occurred, needed to be reported to CQC, as legally required.

People told us that staff supported them with their medicines, and records had evidenced this had happened.

Staff had largely received training to ensure they had skills and knowledge to meet people's needs, though training on other relevant issues had not yet been provided.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives. Staff were aware to ask people’s consent when they provided personal care. Capacity assessments were in place.

People told us that staff were friendly, kind, positive and caring. People or their representatives had been involved in making decisions about how and what personal care was needed to meet their needs.

Care plans included important information on people’s needs, which helped to ensure that their needs were met.

Most calls to people were timely and this issue had improved, though some calls were not on time and caused concern to some people.

People and relatives were confident that any concerns they had would be properly followed up. Most people and relatives were satisfied with how the service was run to provide them with personal care that met their needs.

Staff members said they had been fully supported in their work by the management of the service.

Management had carried out audits in order to check that the service was meeting people's needs and to ensure people were provided with a quality service.

A registered manager was not in place. 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. The current manager and the area manager stated that the application for registered manager was to be submitted in the near future. This issue will be monitored by us as it is a condition of the registration of the service that there is a registered manager in post.

Risk assessments were not consistently in place to protect people from risks to their health and welfare. Staff recruitment checks were not always in place to protect people from receiving personal care from unsuitable staff.

People and relatives we spoke with told us they thought the service ensured that people received safe personal care from staff. Staff had been trained in safeguarding (protecting people from abuse) and staff understood their responsibilities in this area.

We saw that medicines were, in the main, supplied safely and on time, to protect people’s health needs.

Staff had received training to ensure they had skills and knowledge to meet people's needs, though this had not covered some relevant issues.

Not all staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives. Assessments of people's capacity to make decisions were not fully detailed to determine whether they needed extra protections in place.

People and relatives we spoke with all told us that staff were friendly, kind, positive and caring. They told us they had been involved in making decisions about how and what personal care was needed to meet their needs.

Care plans were individual to the people using the service to ensure that their needs were met though this did not include all relevant information such as all of people's preferences, likes and dislikes.

People and relatives told us they would tell staff or management if they had any concerns, they were confident these would be properly followed up. Some comments had not been reported to be followed up appropriately.

Most people and relatives were satisfied with how the service was run, though there were concerns about some calls not being on time. Staff felt they were supported in their work by the senior management of the service.

Notifications of concern had been reported to us, as legally required, to enable us to consider whether we needed to carry out an early inspection of the service. Management had not comprehensively this carried out audits in order to check that the service was meeting people's needs and to ensure people were provided with a quality service.

We previously carried out an unannounced inspection of this service on 23 November 2015. A breach of regulation was found relating to a failure to fully promote people's welfare, and the service was judged to be ‘Requires Improvement’ overall.

After this inspection we asked the provider to produce an action plan stating what they would do to meet legal requirements in relation to the breach. The provider sent this to us. This outlined action that would be put in place to ensure that this breach in regulations was rectified.

A registered manager was in place. 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. The registered manager was not working at the time of the inspection.

People and their relatives we spoke with said they thought the agency ensured that people received safe personal care. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

Risk assessments were detailed to assist staff to support people safely.

We saw that medicines were supplied safely and on time, to help ensure people’s healthcare need were met to protect people’s health needs.

Staff had been safety recruited to ensure they were appropriate to supply personal care to people.

Staff had training to ensure they had the skills and knowledge to be able to meet people's needs, though more training was needed to ensure all people’s needs could be met.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) to allow, as much as possible, people to have effective choice about how they lived their lives.

Staff had an awareness of people's health care needs so they were in a position to refer them to health care professionals if needed.

The people and their relatives we spoke with told us that care staff were friendly, kind, positive and caring.

People, or their relatives, were involved in making decisions about how personal care was to be provided.

Care plans were individual to the people using the service is to ensure that people's individual needs were met, though detail was missing as to people's preferences on how they lived their lives to ensure a fully personalised service was provided to them.

Complaints had been followed up.

People and their relatives were not always satisfied with how the service was run by the management with regard to the manner of office staff. There were some comments for improvement from staff to ensure they were fully supported in their work.

Management carried out audits and checks to ensure the agency was running properly and to measure whether people were provided with a quality service.