The inspection took place on 16 February 2017 and was announced. The provider was given 48 hours’ notice of the inspection. This was because the location provides a domiciliary care service. We needed to be sure that the registered manager would be available to speak with us.
Medacs Healthcare-Leicester provides personal care to adults with a variety of needs living in their own homes. This included older people, people with a sensory impairment, people with physical disabilities, people living with dementia and younger adults. At the time of the inspection there were 140 people using the service. On 7 November 2016 Medacs Healthcare – Leicester started to provide care packages to people who had previously received care from other care providers as part of a new contract. This meant that they had a large number of care calls in one geographic area where they had not worked prior to this date. As part of this process Medacs Healthcare – Leicester transferred staff from other providers to be employed by them. Since this date we had an increased number of concerns about the service raised directly with us. This prompted the inspection to be brought forwards.
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 were protected from the risk of harm at the service because staff had undertaken training to recognise and respond to safeguarding concerns. They had a good understanding about what safeguarding meant and how to report it. The provider dealt with accidents and incidents appropriately and reviewed these to try and prevent reoccurrences. Risks to people’s well-being had been assessed.
We found there were enough staff to support people safely during our visit. However, we found that in November when the provider had started to support people in a new geographic area there had been times when people had not had all of their care calls. People told us that had improved. Staff had been checked for their suitability before starting work.
People’s medicines were handled safely and were given to them in accordance with their prescriptions. The provider agreed to make sure that all medicines that were to be given were written down individually. We found that guidance for staff when to give medicines that were as and when required was not in place. The registered manager agreed that this would be developed.
Staff received appropriate support through an induction and regular supervision. There was an on-going training programme to provide and update staff on safe ways of working.
People chose their own food and drink and were supported to follow a specific diet if this was required. Staff prompted people to contact healthcare services when required to promote their well-being.
People were asked for their consent before they were supported. People were encouraged to make decisions about their care.
People felt that they did not always receive care from the same staff team. Staff told us that they were beginning to work more regularly with the same people to improve this.
People received support from staff who usually showed kindness and compassion. Their dignity and privacy was protected.
People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives. Some people felt that their complaints were not always responded to.
People felt that staff were sometimes late and they were not always contacted about this when it happened. Some people felt rushed while they were receiving support.
People and their relatives had contributed to the planning and review of their support. People had care plans that included information about their likes, dislikes and history. Staff knew how to support people based on their preferences and how they wanted to be supported. People were supported to be as independent as they could be.
The service was led by a registered manager and a manager who understood their statutory responsibility to report to CQC and other agencies significant events that occurred within the service.
Systems were in place which assessed and monitored the quality of the service. The regional operations manager told us that a new audit to review the whole service was to be implemented. People and their relatives were asked for feedback about the service.