Archived: Housing & Care 21 - Milton Keynes

We asked the provider to submit an action plan to tell us how they would meet these regulations in the future; they stated that they would have addressed the breaches of regulation by 29 April 2016. During this inspection we returned to see if the service had made the improvements they stated in their action plan. We found that the provider was now meeting these regulations.

We undertook this focused inspection on 15 June 2016, to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Housing & Care 21 - Milton Keynes on our website at www.cqc.org.uk.

Housing & Care 21 is registered to provide personal care for adults in their own homes. They currently provide support for people with a range of needs, including people who may be living with dementia. On the day of our visit the service provided support for 65 people in their own homes.

The service did not have a registered manager; however there was a manager in post and their application to register was in progress with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Improvements had been made to staff training at the service. There was a clear induction process for new staff, which incorporated the Care Certificate and provided staff with training and support as they learned about their roles. There was also regular on-going training for staff to develop and maintain their skills. The service now had regular access to a regional training coordinator and systems were in place to manage staff training and support them to develop specialist skills required for their roles.

This inspection was announced and took place on 21 and 22 December 2015.

The service did not have a registered manager in post, however they did have a manager who was in the process of registering with the Care Quality Commission. 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.

People did not always see the same carers for their visits. In addition, carers were sometimes late, often due to the distance between calls. The service had identified these issues and were reviewing rotas to improve the allocation of visits.

Members of staff received regular mandatory training, however they did not always receive training in specific areas, such as dementia care.

The provider had policies and procedures to guide them in the use of the Mental Capacity Act (2005), however they were not being regularly implemented by the service.

People received care from staff who had a good knowledge and understanding of abuse, safeguarding and reporting procedures. Where necessary, safeguarding incidents were reported and investigated in full.

Risk assessments were in place to identify areas of potential harm, and to put control measures in place to reduce the likihood of it occurring.

People were encouraged to manage their own medication. If people required support, they received this from trained staff who ensured medication was given correctly. Reporting and auditing procedures were in place, to highlight any concerns with medication administration.

People were provided with support by staff to manage their own food and drink, when required.

The service also supported people to see relevant healthcare professionals if necessary. Care plans contained information about people’s health needs, as well as outlining the specific support they required.

People were treated with kindness and compassion by the service and its staff. Positive relationships had been developed between people and members of staff.

Care plans were produced in collaboration with people and their family members and took their specific needs and wishes into account. People also had important information, such as contact information for the service, readily available.

People’s dignity and respect were upheld by staff, who worked to promote their independence.

People’s care plans were based upon an assessment of their needs and wishes, and were updated regularly, to ensure they were accurate.

The service had systems in place to seek people’s feedback about the care that they received. People were able to get in touch with the service easily, and raise any complaints or concerns which they may have had.

People and staff were positive about the impact the new manager had on the service. They had implemented plans to continue to improve the care being delivered.

A positive and open culture had been established at the service, staff were motivated to perform their roles and the manager was aware of their statutory requirements.

There were quality assurance systems in place to help identify areas for development, as well as those areas which were well carried out.

We found that care and support needs had been assessed before support began, so that arrangements were in place to meet people's requirements. We saw that care plans had been updated as people's needs had changed.

We saw that records were managed safely and destroyed securely when required. We found that some documents in people's records required removal or updating but these did not have an impact on the care people received.

We found that 'spot checks' were being carried out to ensure the quality of the service, and that people had been contacted to ask if they were happy with the care and support they had received.

We found the service to be well managed.

We saw that although the care plans were very comprehensive and incorporated people's wishes, a small number of the care plans had not been reviewed within the last year.