Archived: Mears Homecare Limited - Bristol DCA

Mears Homecare Limited Bristol provides a personal care service for people who require support in their own home.

At the time of our inspection around 65 people were using the service.

There was a registered manager in post. 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.’

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA).

The service was caring. People and their relatives spoke positively about the staff. Staff demonstrated a good understanding of respect and dignity. It was evident people were receiving a service which was personalised to their individual needs.

The service was responsive. Care plans were person centred and provided sufficient detail to provide safe and quality care to people. Care plans were reviewed and people were involved in the planning of their care. There was a robust complaints procedure in place and, where complaints had been made, there was evidence these had been dealt with appropriately.

The service was well-led. Quality assurance checks and audits were occurring regularly and identified actions required to improve the service. Staff, people and their relatives spoke positively about the registered manager.

When we returned on 08 November 2013 we found that improvements had been made. Recent quality surveys showed that people using the service were more positive about communication with the agency. Issues raised in the quality surveys had been followed up and appropriate action taken.

There were systems in place to monitor the quality of the service and to respond where shortfalls or problems were identified.

There were systems in place to record and respond to complaints. The provider had taken action to address a number of staff performance issues.

We looked to see how people's welfare and dietary needs were met, and checked that they were involved in making decisions about their daily lives, what food they ate and where they obtained their meals from. We found that people made their own decisions about what foods they bought from the shops and what meals they ate. People said 'When I go out shopping with my PA, I say what I want to buy and I choose my meals. I eat the meals that I like' and 'I choose what I would like to eat for my main evening meal, and my meal is delivered to me'.

Staff told us about the support they provided to individuals after those 'every-day events' that had been reported to us as concerns (laundry accidents, food that had to be thrown out and support to contact engineers to attend to faulty equipment). They told us what the outcomes were for that person. We were assured that people's care and support needs were being met appropriately.

People felt that their privacy and dignity was respected by care staff and that care was delivered in the way that they preferred. They told us that they were not always consulted about the change of call times or change of care staff. We saw that all the people we visited at home had a care plan in place. People received support to manage their medicines safely.

Staff received appropriate training and supervision.

We found that the provider did not have sufficient systems in place to monitor the quality of the service and did not always take action to rectify any problems which arose with the delivery of the service. We found that when people complained verbally to office staff these comments were not always logged as complaints which meant they were not followed up. People told us they felt their dissatisfactions with the service were ignored.

Staff we spoke with had a clear understanding of the types and signs of abuse and understood what action they should take if they suspected abuse had taken place. They now knew that if they felt their concerns were ignored they could contact external agencies. We observed that both people using the service and staff appeared much happier and more relaxed.

People could now be confident that their complaints would be listened to and responded to. The provider had taken steps to ensure that people understood the complaints procedure and were supported to make a complaint.

We found evidence that these allegations were accurate. We found that care was arranged for the convenience of staff and people were treated disrespectfully. People told us they were not consulted about the times of their visits which were arranged according to staff convenience. People's care was not reviewed when their needs changed. We found regular omissions in the recording of medication.

People were not protected from abuse and some people experienced psychological abuse from staff. Some people using the service felt humiliated and powerless. People told us they were afraid to complain and one person told us they were 'frightened they would be evicted if they complained'.

People were not supported to make complaints. Complaints were not recorded or investigated properly and the provider's complaints policy was not implemented by members of the care staff. Whilst people told us some care staff were good this was overshadowed by poor care received from other members of the team.