Archived: Meridian Health and Social Care - Nottingham

Sevacare – Nottingham is a domiciliary care service which provides care services to adults living in their own homes. Sevacare was registered to provide personal care to 171 people aged 65 and over at the time of the inspection.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Systems were in place to assess and manage potential risk for people. People received their medicines in a safe way that was prescribed by their GP. People were protected from avoidable harm and felt safe with the staff who cared for them. Safe recruitment processes were in place to ensure staff were safe to care for people. People were protected from the risk of cross contamination from infection. People confirmed the personal protective equipment used by staff on a daily basis to ensure people were kept safe. When things went wrong the service had systems and processes to ensure they reduced any risk for people.

People’s needs were assessed before the provider took on the care package to ensure the service were able to support people’s needs. Goals and aspirations were supported to ensure people achieved their potential. The principles of the Metal Capacity Act were taken into consideration to ensure people’s choices were in their best interest. Dietary needs were assessed and monitored. Staff worked well with other health care professionals. People were responsible for their own home environment. People were supported to access health care when needed.

People were treated with respect and kindness. Where concerns were identified the registered manager put processes in place to address any concerns, such as language barriers. People were supported to express their views in a variety of ways. Dignity was adhered to.

People were supported by staff who knew their choice and preferences. Care plans were person centred. Care planning was personised to ensure people had choice and control. However, we found inconsistencies with some of the care call times. Systems were in place to monitor and respond to complaints. End of life discussions had taken place and staff were trained to support people at the end of their life. People communication needs were assessed and reviewed regularly.

The registered provider was aware of the duty of candour. The registered manager provided a positive, focused culture. People were involved in discussions of their day to day care. The service built up and maintained a close working relationship with other health care professionals.

Rating at last inspection 08 June 2016

The last rating for this service was Good (published 20 July 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We have made a recommendation about the management of some of the monitoring systems.

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

The service 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.

People told us that they felt safe when receiving support from the staff and staff understood their responsibilities to protect people from the risk of abuse. Any risks to people’s health and safety were appropriately assessed and a management plan put into place to reduce the risks.

There were sufficient staff available to ensure that all calls could be allocated and any unplanned absences were covered. People received any support they needed to manage their medicines and action was taken to address any medicines errors and omissions.

Staff were provided with the knowledge and skills to care for people effectively and received regular supervision and support. People received the support they required to have enough to eat and drink and, where required, staff supported them to access healthcare professionals.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received. We also found staff were aware of the principles within the MCA and how this might affect the care they provided to people. Where people had the capacity they were asked to provide their consent to the care being provided.

People were cared for by staff who had developed caring relationships with them. People, or a relative, were able to be involved in planning their own care and making decisions. People were treated with dignity and respect by staff who understood the importance of this.

People did not always receive the care they required within the agreed time frames because staff sometimes arrived early or late. Staff felt that they did not always get the required amount of time to travel between calls. People could be assured that any complaints they made would be taken seriously and appropriately responded to.

The culture of the service was open and honest and staff felt comfortable raising issues of concern. The registered manager led by example and there were clear staffing and decision making structures in place. People were asked for their opinion about the quality of the service and there was an effective programme of audits which resulted in improvements being made.

Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary, please read the full report.

We spoke with five people who used the service and one relative. We also spoke with the manager and four other members of care staff. We looked at written records, which included copies of people's care records held in the office, staff personnel files and quality assurance documentation.

Is the service safe?

We saw that care plans and risk assessments were informative and regularly reviewed. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care. There were clear systems in place for the administration of medication.

People were protected by safe and effective recruitment practices. People were cared for by staff who were properly trained and supported to develop professionally.

Is the service effective?

People we spoke with were satisfied with the care and support they received and were complimentary about the care workers. This was consistent with feedback reported in the provider's own annual quality assurance survey. People were given information and support to help them understand the care and support available to them.

Is the service caring?

We spoke with five people who used the service and one relative. One person said to us, "My carers are very kind and considerate. I'm very happy with the service." Another person said, "I'm very happy this agency has agreed to take me on. It's much better than the last one I had." Another person said, "My carers are very nice and they do what they are supposed to do."

Is the service responsive?

One person said, "They give a good service. I had some problems in the past, but I spoke to the management and it's all been resolved now."

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Two people who used the service and four staff members told us that the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the service. The provider took account of complaints and comments to improve the service.

Is the service well led?

Staff said that they felt well supported by the manager and the management team, and they were able do their jobs safely. The manager had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

We spoke with two relatives of people who were using the service. One relative told us, 'The carer we get is fantastic. They go above and beyond to help us out.' We spoke with two care staff who told us that generally they felt they had enough information about the people they were caring for.

We spoke with six people who were using the service and asked if they felt safe while the carers were with them. Each person indicated that they did feel safe while receiving care and support. People were not fully protected from the risks associated with the unsafe use and management of medicines.

Appropriate pre-employment checks were carried out before staff started work. We spoke with six people who were using the service who told us they felt they could give their opinion about the service at any time. One person said, 'I would always phone the office if I felt I needed to.' Another person told us, 'They phone me from time to time to check if everything is ok.' Records relating to the care and support provided to people had not always been completed and could not always be located promptly when required.

We spoke with three people who were using the service who told us they found the care staff were polite and treated them with dignity and respect. One person said, 'The staff are very nice and always polite.' Another person told us, 'Most of the staff are polite, they respect my privacy and my property.'

We spoke with three people who were using the service who told us that they were generally happy with the care they received. We looked at the care plans of three people who were using the service. The care plans gave staff some basic guidance about the support each person required on each visit. However the care plans we saw did not always give staff the required detail.

We spoke with three people who were using the service who told us that they had always felt safe with the care staff who supported them. One person said, 'I've never had any concerns in that regard.' We saw that the records relating to cash transactions were being maintained inconsistently.

We spoke with three people who were using the service who told us that they felt staff were well trained and appeared to be competent. One person said, 'They seem to be well sorted. The staff always know what to do and get straight to it.'