You are here

This service was previously registered at a different address - see old profile

We are carrying out a review of quality at 121 Care & Mobility Limited. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 3 April 2019

During a routine inspection

About the service:

121 Care and Mobility is domiciliary care provider that was providing personal care to people in their own homes. People receiving support had a range of needs including, the elderly, people that were living with dementia. At the time of our inspection there were 280 people receiving personal care.

People’s experience of using this service:

• The provider had made changes to improve the service for people. Care plans had all been reviewed to make sure that they reflected the care that people needed and people told us that they had been involved with this.

• Care was person centred, achieved good outcomes and people were offered choice and involved wherever possible.

• People's care plans reflected their needs and preferences and staff could explain specific care that people required.

• People received care from staff who were well supported with induction, training and ongoing supervision.

• People knew how to complain and that any concerns would be listened and responded to by the provider. Actions were taken as a response to complaints.

• Feedback was sought and used to make improvements. Feedback from people, relatives, health care professionals and staff were all positive.

• Quality monitoring systems included audits, checks on staff practice and checks on people's satisfaction with the service they received, using questionnaires.

• The provider has systems in place to ensure they kept up to date with developments in the sector and changes in the law.

• Lessons were learnt and used to make improvements.

• The service was led by an experienced, competent manager who understood their role and responsibilities, as did staff. The service had a clear management structure and people had confidence in the manager and provider.

Rating at last inspection: At the last inspection the service was rated Inadequate (report published on 09 October 2018). This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

At this inspection on 3 April 2019 we found that sufficient progress had been achieved to meet all the breaches of regulations.

Why we inspected: This was a comprehensive planned inspection based on the previous rating.

Follow up: We will continue to monitor this domicillary care agency and plan to inspect in line with our re-inspection schedule for those services rated Good

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 12 June 2018

During a routine inspection

We carried out an announced comprehensive inspection on 12th June 2018. Following this inspection, we received a number of additional concerns which prompted further regulatory action. On the 10th and 11th July 2018 we carried out a further unannounced inspection so that we could fully assess the potential of ongoing risk to people.

121 Care and Mobility Limited is a domiciliary care agency, it provides personal care to people living in their own homes. The service provides support visits to people in Whitstable, Herne Bay, Faversham and surrounding areas who are mainly older people, and some younger adults. At the time of the inspection they were supporting 292 people. Not everyone using 121 Care and Mobility Limited 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.

At the time of the inspections in June and July 2018, the registered manager’s registration was being processed by CQC. The registration is now completed and there is a registered manager at 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.

At our previous inspection on 21 and 22 February 2017, we rated the service as Requires Improvement having found breaches of Regulation 12 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. People were at risk because the service was not assessing health related risks and ensuring measures to keep people safe were in place. Audit systems were not utilised effectively to identify and respond to shortfalls identified by people and staff. We asked the provider to take action to meet the regulations. We received an action plan on 11 May 2017 which stated that the provider would be meeting the regulations by 01 July 2017.

At this inspection, we found that the previous breaches had not been met and that there were further breaches of Regulations relating to: not ensuring that people were kept safe, failing to ensure care plans were reviewed regularly to reflect people’s needs; not consistently protecting people’s dignity; not meeting the requirements of the Mental Capacity Act; not protecting people from risks; not ensuring that systems and processes for safeguarding people had been put in place; and not responding to safeguarding risk in a timely manner, not meeting nutritional and hydration needs effectively; not ensuring governance systems monitor and improve the quality of the service; not ensuring sufficient competent staff were delivering the care and not ensuring an accurate CQC rating was displayed at all times.

People had not been kept safe from risk of harm. Risks had not been adequately managed and risk assessments had not been updated in a timely manner to ensure that risks had been correctly identified and actions put in place to lessen the risks.

Environmental risks had not been correctly assessed so that necessary infection control measures could be introduced to provide a safe working environment in people’s homes, for example during food preparation.

The provider had not carried out adequate individual risk assessments for people joining the service and there was insufficient detail to individualised care-related risk assessments to support people’s specific health and care needs, their mental health needs, medicines management, and equipment requirements.

Medicines had not been managed safely and people had not always received their prescribed dosage on time. Medicine administration was not correctly recorded and medication errors had occurred.

People’s changing needs had not been

Inspection carried out on 21 February 2017

During a routine inspection

121 Care and Mobility provide care and support to people in their own homes. The service is provided to mainly older people and some younger adults. At the time of the inspection the service was providing up to 5000 visits per week to people who needed domestic calls and or visits to help with personal care support. At the time of inspection approximately 375 people were receiving support with their personal care. The service provides care and support visits to people in Whitstable, Herne Bay, Faversham and surrounding areas.

The service is run by an experienced 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.

Risks associated with people’s care and support had been identified, but there was not always sufficient guidance in place for staff, to aid risk management and help ensure people were safe.

Comprehensive audits and systems in place to monitor that the service ran efficiently had not been utilised effectively and had not picked up that although most people found the office staff kind and courteous, they did not always tell people about changes to their calls or ring back when messages were left. Care staff also felt communication from the office could be improved upon, and supervisions had not picked up or addressed staff feelings of being unsupported. Audits of care records had not identified where there were gaps in risk information. People had opportunities to provide feedback about the service provided, but they did not in turn receive feedback about how their comments were used to help service development.

People told us they received their medicines when they should and felt their medicines were handled safely. They said that they felt safe using the service and when staff were in their homes.

The service had safeguarding procedures in place and staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns in order to keep people safe.

People had their needs met by sufficient numbers of staff. Most people told us staff generally arrived on time and that on the whole they received support from a team of regular staff. New staff underwent an induction programme, which included relevant training and shadowing of experienced staff, until they were competent to work on their own.

People told us staff always asked for their consent before carrying out activities at each visit. People were supported to make their own decisions and choices although some were supported by relatives. The Mental Capacity Act (MCA) provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood this process and was working to the principles of the MCA.

People were supported to maintain good health and they told us staff were observant in spotting any concerns with their health and taking appropriate action.

People were involved in the initial assessment and the planning of their care and support and some had chosen to involve their relatives as well. Care plans reflected the care and support people received. People told us their independence was encouraged wherever possible.

People felt the majority of staff were kind and caring. People said they were comfortable with staff in their home and undertaking their personal care they said staff listened and acted on what they said. People were treated with respect and their dignity and privacy protected. People said they felt able to raise concerns if they