4 November 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
This inspection was carried out by one inspector and two Experts by Experience who made telephone calls to people and relatives of people using the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service short notice of the inspection as we were mindful of the impact and added pressures of the COVID-19 pandemic on the service. This meant we took account of the exceptional circumstances and requirements arising as a result of the COVID-19 pandemic.
Inspection activity started on 15 October 2020 and ended on 21 October 2020. We visited the office location on 15 October 2020. The other days were spent reviewing records, speaking to staff, people and their relatives who used the service.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We reviewed the provider’s action plan as well as information we had received about the service since the last inspection.
During the inspection
We spoke with the registered manager and a field care supervisor. We reviewed a range of records. This included five people’s care and four people’s medicine records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We spoke with six people using the service and 14 relatives of people using the service. We also spoke with seven care staff. We looked at a further four care plans and three people’s medicine records. We continued to seek clarification from the registered manager to validate evidence found.
4 November 2020
About the service
Mariama Care Ltd trading as Kangaroo Care is a domiciliary care service. It provides personal care to people living in their own homes and flats in the community. The service supports older people with a range of physical and sensory disabilities as well as people living with dementia. At the time of this inspection there were 55 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
At the last inspection in February 2019, we identified several issues and concerns which meant that people may not have always been received safe and good quality care. During this inspection we found that the registered manager had implemented robust systems and processes which had led to significant improvements to the quality of care people received.
People and relatives told us that they felt safe and re-assured with the care and support delivered and spoke positively about the way in which the service was managed.
Risks identified with people’s health, care and support needs had been comprehensively assessed with clear guidance on how to manage and minimise risk to keep people safe and free from harm.
People received their medicines safely and as prescribed. Policies and systems in place supported this.
Recruitment checks were complete and adequately assessed staff suitability to work with vulnerable adults. People and relatives told us that they were supported by regular care staff who generally arrived on time.
Care staff had access to the required personal protective equipment (PPE), information and guidance to prevent and control the spread of infection.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported with their nutrition and hydration where this was an assessed need. Where required the service supported people to access health and social care professionals to support their well-being.
Care staff spoke positively about the registered manager and management team and stated that they received the required training and support to carry out their role.
The overall management oversight of the service had improved since the last inspection. The registered manager had implemented audits and checks to monitor the quality of care and ensure where issues were identified these were addressed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 17 April 2019) and there were breaches of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We had carried out an announced comprehensive inspection of this service on 19 and 20 February 2019. Breaches of legal requirements were found which included safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mariama Care Ltd on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.