Background to this inspection
Updated
23 November 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 6, 11 and 12 February 2015 and was announced. The service was given 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. The inspection team consisted of one inspector.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law.
Prior to the inspection we spoke with two commissioners of the service. During the inspection we spoke with the manager, the care coordinator, the office administrator, a senior care worker, two care workers and a manager from another service within the provider’s care group. We reviewed 13 people’s care plans, 12 care staff recruitment and supervision records, and information relating to the management of the service.
We visited nine people at their homes and spoke with them about their care and looked at their care records. We observed some aspects of care, such as care staff preparing people’s meals and the administration of medicines.
Following the home visits we spoke with a further nine people, two of their relatives and 15 care staff on the telephone.
Updated
23 November 2015
This inspection took place on 6, 11and 12 February 2015 and was announced. The service was given 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available.
Magnata Care provides a domiciliary care service to enable people living in Basingstoke, Maidenhead and West Berkshire to maintain their independence at home. There were 94 people using the service at the time of the inspection, who had a range of physical and health care needs. Some people were being supported to live with dementia, whilst others were supported with their rehabilitation after experiencing a stroke.
The service had not had a registered manager in place since 30 April 2014. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The manager in place at the time of our inspection in May 2014 had begun the process to become the registered manager but they resigned at the end of November 2014, just before the process was finalised. The manager at the time of this inspection has begun the process to become the registered manager.
At our previous inspection on 30 May 2014 the provider was not meeting the requirements of the law in relation to people’s care and welfare, staffing, supporting workers and assessing and monitoring the quality of the service. Following the inspection the provider sent us an action plan and informed us they would make improvements to meet these requirements by 30 October 2014.
During this inspection we found improvements had been made in relation to people’s care and welfare, staffing levels and support for workers. Improvements were still required in relation to assessing and monitoring the service.
The provider had not protected people against the risks of inappropriate or unsafe care by effectively operating systems to assess and monitor the quality of service. When shortfalls and concerns had been identified no action had been taken by the provider to make improvements.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to 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 this report.
Since the last inspection staffing levels had improved and there had been a significant reduction in the number of people using the service. The manager had returned 20 packages for care to be provided to people by alternative providers. However, three people had experienced some missed or mistimed calls. One of three senior care staff members had left the service recently and had not been replaced. Although the manager completed the calls herself to address any missed calls or lateness at the time of our inspection there was a risk that this may not be sustainable in the long term.
People told us they felt safe and trusted the care staff. One person said “They know what they are doing and how I like to be supported so I never have to worry.” Care staff had completed safeguarding training and had access to local authority guidance. They were able to recognise if people were at risk and knew what action they should take. People were kept safe because safeguarding incidents were reported and acted upon.
Needs and risk assessments had been completed and reviewed regularly with people and where appropriate, their relatives. Where risks to people had been identified there were plans to manage them effectively. Care staff understood the risks to people and followed the guidance to safely manage these risks.
Care staff responded flexibly to people’s individual wishes and changing needs and sought support from healthcare specialists when necessary. People’s dignity and privacy were respected and supported by care staff.
The provider had taken action to ensure care staff received supervision, appraisals and training. People’s care was provided by care staff who received appropriate training and support. Care staff had received an induction into their role which met recognised standards within the care sector. The manager and senior care staff completed checks of care staff competence to undertake their roles safely.
Care staff had undergone appropriate recruitment checks as part of their application and these were documented. These included the provision of suitable references and a Disclosure and Barring Service (DBS) check. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.
Medicines were administered safely in a way people preferred, by trained staff who had their competency assessed annually by the manager and senior support workers.
Care staff completed training on the Mental Capacity Act (MCA) 2005 and understood their role. People told us staff had sought their consent before delivering their care. Where people lacked the capacity to consent the principles of the Mental Capacity Act 2005 had been followed to make best interest decisions on their behalf.
People’s care plans documented what support they required in relation to nutrition and hydration. People were supported to ensure they had enough to eat and drink.
People told us care staff were caring and treated them with dignity. One person said “Nothing is too much trouble for them. The carers are so kind and considerate.” We observed care staff provided people’s care in a warm, friendly and compassionate manner. People told us they experienced good continuity of care from care staff whom they had grown to know and trust and from newly recruited care staff. One person told us, “If the carers are new they read my care plan but always ask me what I want and how I like things done.”
People were treated as individuals and told us their care was designed to meet their specific requirements. During our last inspection some people told us they frequently received support from care staff of a different gender to that they had requested. At this inspection people told us they were receiving support from care staff of their preferred gender.
The manager had improved people’s care plans and ensured they had been reviewed. People had accurate care plans and these were stored securely in the office.