Archived: Mayfair Homecare-Trellis House

At the time of the inspection, the service was providing personal care to 30 older adults aged 64 and over.

People’s experience of using this service:

• The service was not consistently safe. Risks to people's health and safety were not sufficiently assessed to ensure safe care. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

• The service was not consistently well-led. There were no robust quality assurance processes in place to monitor the quality of the services provided for people, including accuracy of care records. We made a recommendation about this.

• Staff were not supported to up-date their knowledge and skills in all areas required for their role. We made a recommendation about this.

• People’s received the necessary support to manage their medicines as prescribed, but staff were not provided with guidelines on how to support people to take PRN (‘as required’) medicines safely.

• The staff team were trained and applied the Mental Capacity Act 2005 (MCA) principles in practice as necessary.

• Processes were followed to review and monitor staff’s developmental needs.

• Staff had to undertake appropriate checks before they were employed by the service.

• Systems were in place to provide immediate support to people if staff had noticed people being at risk to harm or when incidents and accidents took place.

• Staff aided people if they required support to prepare their meals or attend to their health needs.

• People were treated with dignity and kindness and staff were respectful towards people’s privacy.

• Staff encouraged people’s independence and decision making about their daily activities.

• Care plans included personal information about people.

• People provided feedback about the quality of the services they received.

• Staff received guidance on how to support people at the end of their lives.

• People felt that the registered manager was responsive to their care needs.

• There was a clear management structure in place with shared responsibilities to ensure good care delivery for people.

Rating at last inspection:

• The service was previously inspected on 11 October 2016 and was given a rating of Good in all key questions.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspection will be planned in line with our re-inspection programme. If any concerning information is received, we may inspect the service sooner.

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

Sevacare – Trellis House provides an extra care scheme. There are 42 flats as part of the scheme. At the time of our inspection 39 flats were occupied, with 35 people receiving personal care. The service is staffed 24/7. Staff are allocated to support people at allocated times and are also available to attend out of these times in an emergency or as the need arises.

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 received the support they required and at the time they required it. There were sufficient staff to meet people’s needs and there was clear allocation as to who staff were supporting on each shift. Staffing arrangements were flexible to take account of any additional support people required for example if their scheduled visit overran due to the person needing more support that day or in response to a person activating an alarm.

Safe staff recruitment practices were in place to ensure staff were suitable to work with people. Staff had recently completed Sevacare’s mandatory training to ensure they were up to date with current good practice. The team leaders and registered manager regularly supervised staff through one to one meetings and direct observations to ensure they had the knowledge and skills to undertake their duties.

Staff had built caring relationships with people. People were complimentary about the staff supporting them and how the support was provided. People were treated with respect and their privacy and dignity was maintained. Staff had developed additional resources to aid communication for people with limited speech or who did not speak English.

Staff liaised with people and involved them in decisions about their care. Staff adhered to the Mental Capacity 2005 code of practice and the majority of people consented to care decisions. Where people were not able to consent to decisions, staff liaised with the local authority and the person’s lasting power of attorney to ensure any decisions made on the person’s behalf were in line with the person’s best interests. Staff delivered support in line with people’s wishes and preferred daily routine.

Staff were knowledgeable about the level of support people required. This included in relation to personal care, medicines management, meal preparation and accessing healthcare services. Staff liaised with other healthcare professionals involved in the person’s care to ensure they had up to date information about their needs. If staff felt people’s needs had changed and the current care package no longer met their needs, this was discussed with the funding authority and their needs were re-assessed.

Care records outlined what support people required. Information was also included in people’s records about the risks to their safety and the plans in place to manage and mitigate those risks. We saw that some people’s care records did not always outline how their health needs impacted on their support needs. Whilst staff were aware of this information it was not recorded. We discussed this with the registered manager who said they would ensure this information was captured in people’s care records.

Processes were in place to safeguard people from harm. Staff were aware of their responsibilities to safeguard people and reported any concerns to the management team, who liaised with the local safeguarding team as and when necessary.

Systems were in place to review and monitor service delivery. This included a programme of audits, collection of key performance data, review of incidents, complaints and any safeguarding concerns, as well as obtaining feedback from people and staff about service delivery. Where improvements were required these were identified and addressed.