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Review carried out on 9 September 2021

During a monthly review of our data

We carried out a review of the data available to us about Medacs Healthcare PLC on 9 September 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Medacs Healthcare PLC, you can give feedback on this service.

Inspection carried out on 22 November 2018

During a routine inspection

About the service: Medacs Healthcare is registered as a domiciliary care agency providing the regulated activity 'personal care' to the people who live in their own homes. The service was providing personal care to 201 people aged 65 and over at the time of the inspection.

People’s experience of using this service: The management of medicines had improved which ensured they were administered as prescribed and staff had guidance to do this safely. Risks to people were assessed and records contained clear guidance for staff to follow. Staff knew how to respond to possible harm and how to reduce risks to people.

The provider had embedded quality assurance systems to monitor the quality and safety of the care provided. People and relatives were asked for their views and their suggestions were used to improve the service.

People were safe and protected from avoidable harm as staff knew how to recognise and respond to concerns of ill-treatment and abuse. Lessons were learnt about accidents and incidents and these were shared with staff members to ensure changes were made to staff practice or the environment, to reduce the risk of further occurrences.

The provider followed effective infection prevention and control guidance when supporting people in their own homes. The equipment that people used was maintained and kept in safe working order and the provider undertook safety checks with people at their home addresses.

There were enough skilled and experienced staff to meet the needs of people who used the service. Recruitment checks were completed on new staff to ensure they were suitable to support people who used the service. A comprehensive induction and training programme was completed by all staff.

A detailed needs assessment was carried out to assess people's needs and preferences prior to them receiving a service. People's personal and health care needs were met and detailed care records guided staff in how to do this. Where staff noted a concern they quickly involved healthcare professionals.

Where required, people were supported to have sufficient to eat and drink and their health needs were regularly monitored. Staff followed the advice health care professionals gave them. Staff had guidance if they needed to provide people with end of life care.

Staff showed a genuine motivation to deliver care in a person centred way based on people's preferences and likes. People were observed to have good relationships with staff.

People told us they felt well cared for by staff who treated them with respect and dignity. People told us they were listened to and were involved in their care and what they did on a day to day basis. People's right to privacy was maintained by the actions and care given by staff members.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005. People told us they were involved in making every day decisions and choices about how they wanted to live their lives.

A complaints system was in place and there was information so people knew who to speak with if they had concerns.

More information is in the full report below.

Rating at last inspection: Requires Improvement (published 1 January 2018)

Why we inspected: This was a planned inspection based on the previous rating of requires improvement. The overall rating has improved to good.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good. If any concerning information is received we may inspect sooner.

Inspection carried out on 10 October 2017

During a routine inspection

This was an announced inspection carried out on the 10, 11, 26 and 27 October 2017. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the office to meet with us. At the time of the inspection the service was supporting 219 people with personal care.

There was a newly registered manager in post at the time of the inspection. 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.

At the last inspection in March 2017, the service was rated as requires improvement. The safe domain was rated inadequate. There were three breaches of regulation within this domain. These were regulation 9 Person centred care, regulation 12 safe care and treatment and regulation 13 safeguarding service users from abuse and improper treatment. There was also a breach of regulation 17 good governance within the well led domain. Following the inspection, the provider sent us an action plan telling us what actions they were going to take to ensure they met the regulations. At this inspection, we found that some improvements had been made.

We found the service was not working in accordance with the Mental Capacity Act 2005 and had not followed the correct process to make sure any actions taken were in people's best interests when this was required.

This represented a breach of Regulation 11 HSCA RA Regulations 2014 Need for consent. You can see what action we have taken at the end of this report.

We found issues relating to the management of medicines. Although the provider was responsive at the time of the inspection, the processes in place for quality assurance had not identified these issues.

Risk management plans did not always contain the information staff needed to support people safely and manage all risks identified.

People spoke positively about the staff that supported them and told us they were always treated with care, respect and kindness. Staff were respectful of people's privacy and maintained their dignity. Staff had developed good relationships with people and were familiar with their needs, routines and preferences.

People told us they felt safe and would speak to staff if they were worried about anything. The manager understood their responsibilities for safeguarding people and staff were trained to understand and recognise abuse. They knew who to report concerns about people's safety and welfare within the organisation and knew where to access contact numbers to external agencies if necessary.

Recruitment processes were robust to make sure staff were safe to work with vulnerable people.Staff had sufficient knowledge and skills to meet people's needs effectively. They completed an induction programme when they started work and they were up to date with the provider's mandatory training.

People were supported to access health and welfare professionals when they needed to. People were supported with their dietary needs in accordance with their care plan.

There was a complaints procedure in place at the service. The people we spoke with said they would speak with one of the staff or the manager if they had any concerns.

Satisfaction surveys were sent out by the provider to seek the opinions and views of people who used the service. Systems were in place to monitor

the quality of the service and people's feedback was sought in relation to the standard of care and support.

One breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were found during this inspection. You can see what action we told the provider to take at the end of this report.

Inspection carried out on 7 March 2017

During a routine inspection

This was an announced inspection carried out on the 7, 10 and 14 March 2017. This was the first inspection of the service since they became newly registered, due to a change of address in January 2017.

Medacs Healthcare PLC Leeds is a domiciliary care agency that provides support to people in their own homes in the Leeds area.

At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC); however, they had left the service recently. A new manager had been appointed but was not in post at the time of the inspection. 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.

Medicines were not managed safely. We found one person was receiving doses of their pain relief medication too close together which put their health at risk. We saw gaps in the recording of medicine administration and found cream charts did not show people were receiving creams as prescribed.

A number of safeguarding concerns had been reported to CQC by the local authority. These indicated people who used the service had been put at risk of harm from missed calls, poor moving and handling techniques, issues with medication and agreed tasks not being completed. We found staff were able to describe different types of abuse and what they would do to report alleged abuse but we found the systems in place to safeguard people had not been followed at all times.

People told us they felt safe using the service and they overall received their calls on time. However, some people said they did not always know which care worker would be visiting them or receive the care they expected at the time they had agreed.

People told us staff were generally kind to them and treated them with dignity and respect. They said staff were well trained to carry out their role. People were supported by staff who had received induction training which included shadowing more experienced staff. Recruitment of staff was managed safely.

There were systems in place to ensure people’s nutritional and hydration needs were met. People’s physical health was monitored as required. This included the monitoring of people’s health conditions so appropriate referrals to health professionals could be made if needed.

People told us they were asked to consent to their care. However, the Mental Capacity Act 2005 legislation had not been fully implemented within the day to day delivery of care for people. The service had recognised this and had planned improvements in this area.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The care plans included risk assessments. However, we suggested some improvements were needed to care plans and risk management plans to ensure they gave staff detailed guidance on meeting people’s needs.

The service had not been well-led as the system failures identified during the inspection had not been identified through the audit systems and quality control systems in place. A number of people who used the service said communication from the agency was at times poor and the agency had been slow to respond to concerns raised.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.