Archived: Mears Care Mansfield

There was a registered manager in post at the time of our 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 time of the inspection, 247 people received some element of support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection on 23 June 2017 the service was rated as ‘Requires Improvement’ overall. An action plan was submitted which stated how the service would become compliant. At this inspection, they improved the overall rating to ‘Good’, however the question, ‘Is the service safe?’ remains at ‘Requires Improvement’.

Improvements had been made to the punctuality of the staff; however, people still felt staff arrival times could be improved further. Medicines were managed safely and staff recording errors were monitored and acted on, however the number of recording errors remained high. Improvements had been made to the way the risks associated with people’s care had been assessed and acted on. People told us staff made them feel safe when staff supported them. Robust staff recruitment processes were in place. Staff understood how to reduce the risk of the spread of infection. The provider had processes in place to investigate accidents and incidents and to learn from mistakes.

People’s care was provided in line with current legislation and best practice guidelines. People felt staff understood how to support them. Records showed the number of staff with training that was out of date had significantly reduced and courses were booked where needed. Staff now received professional development and supervision. People’s nutritional needs were met. Other health and social care agencies were involved where further support was needed for people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. A review was currently underway to ensure all people had the required assessments in place where needed.

People liked the staff who came to their home and felt they were kind, caring and treated them with respect. People told us they were involved with decisions about their care and staff encouraged independence wherever possible. People told us they would like to have a more consistent team of staff to support them and the registered manager had taken action to address this. People’s records were handled in line with the Data Protection Act

Assessments of people’s needs were carried out before joining the service to ensure staff were able to support them effectively. Improvements had been made to ensure people received care that was in accordance with their personal preferences. People felt care staff responded to their complaints effectively although they felt the performance of office based staff could improve. The registered manager had put processes in place to act on this feedback. People’s diverse needs were discussed with them during their initial assessment and then during further reviews.

The registered manager had made significant improvements since the last inspection. They had acted on feedback from people and staff and put measures in place to continue this improvement. They acknowledged that staff punctuality was still a concern; however, this had improved since the last inspection. Robust quality assurance systems were now in place to aid the registered manager in continually improving the service. They were supported by a dedicated staff team and the provider in doing so. The registered manager carried out their role in line with their registration with the CQC. High quality staff performance was rewarded.

On the day of our inspection there was a registered manager in place. 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 current registered manager has been registered with the CQC since 21 February 2017; however it has only been in the past two months that they have worked fulltime at the service.

People told us they felt their safety may be placed at risk because staff regularly arrived late to support them in their homes. Records showed up to 37% of all calls were at least 15 minutes late. However, when staff did arrive people felt safe when they were in their homes. Risks to people’s safety were assessed and reviewed however many of these assessments lacked detail and did not always provide staff with sufficient guidance on how to reduce the identified risks. Safe recruitment processes were in place. People’s medicine administration records were not always accurately completed.

People were supported by staff who completed an induction and training prior to commencing their role. However, records showed that 25% of all care staff had not completed refresher training in a number of key areas needed to provide effective support for people. Staff received some supervision of their work but not all had received sufficient amounts to enable the registered manager to be confident they were completing the roles effectively.

The principles of the Mental Capacity Act (2005) had not always been appropriately followed when decisions were made about people’s care. Guidance for staff to communicate effectively with people living with dementia was limited. People were supported to maintain good health in relation to their food and drink intake. People’s day to day health needs were met by staff.

People found the care staff to be kind, and caring; they understood their needs and listened to and acted upon their views. People felt the care staff treated them with dignity and respect with some people enjoying positive, friendly relationships with them. People were involved with decisions made about their care and were encouraged to lead as independent a life as possible.

People told us their personal preferences were not always respected. Some people told us they did not always receive the same staff at their home, and new staff did not understand how to support them. Additionally, some people had specifically asked for male or female staff to support them but this choice was not always respected. Guidance for staff on how to support people living with dementia was limited. Some people felt their care needs were regularly reviewed, whilst others felt they were not involved with the reviewing of their care. Some people felt the office staff responded to their complaints effectively, whilst many others felt they did not.

Current quality assurance processes were not effective in ensuring that people received a high quality service at all times. Some of the issues highlighted within this report had been identified by the registered manager, with some action taken to address them, however further work and improvements were needed. Many people felt the office staff did not respond appropriately when they wished to make changes to their care package, whilst many people also did not know who was currently managing the service. A survey had been carried out to gain people’s views, however the results of these surveys had not yet been analysed, nor an action plan for improvement put in place. Staff understood how to report serious concerns via the provider’s whistleblowing policy.

We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the back of this report.