3 November 2018
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.
This inspection took place on 4, 5 and 6 September 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure staff would be available to meet with us. We made telephone calls to people who used the service and visited the office location on the 4 September to review care records and policies and procedures and talk with staff. We visited people at home on the 5 September and completed the inspection with further telephone calls to people and staff on the 6 September.
The inspection team consisted of an inspector and assistant inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert-by-experience’s area of expertise was community based social care services.
We looked at information received from local authority commissioners. Commissioners are people who work to find appropriate care and support services for people and fund the care provided. We also reviewed notifications that the provider had sent us. Notifications are changes, events or incidents that providers must tell us about.
We spoke with seven people using the service and seven people’s relatives. We also spoke with the provider, registered manager, training manager, a care visit scheduler, two senior care staff and four care staff. We looked at records relating to all aspects of the service including care, staffing, and quality assurance. We also looked at five people’s care records and five staff recruitment files.
3 November 2018
This announced inspection took place on 4, 5, and 6 September 2018. Melton Care Services Limited was first registered with the Care Quality Commission on 9 August 2017; this was the first comprehensive inspection of the service.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults. At the time of inspection, the provider was supporting 51 people with personal care.
Not everyone using Melton Care Services Limited receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
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.
Staff demonstrated their understanding of MCA and the need to ensure that people's care and support was provided in the least restrictive way. However, there was a lack of recorded MCA assessments and best interest decisions in place for people. The registered manager had identified this and was working with the local authority to ensure that people’s mental capacity was assessed when needed.
People were supported in a safe way. Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by senior staff. People had risk assessments in place to cover any risks that were present within their lives, but also enabled them to be as independent as possible.
There were safe systems in place for the administration of medicines and people received their medicines as prescribed. Staff supported people in a way which prevented the spread of infection. Staff used the appropriate personal protective equipment to perform their roles safely.
Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. References and security checks were carried out as required. Staffing levels were suitable to meet people's needs, and the staffing planner showed that staffing was consistent.
Staff attended induction training where they completed mandatory training courses and were able to shadow more experienced staff. Staff told us that they were able to update their mandatory training with refresher courses. Staff were well supported by the registered manager, senior team and provider, and had one to one supervisions.
Where needed, staff supported people to have access to suitable food and drink. Staff supported people to health appointments when necessary. Health professionals were involved with people's care as and when required.
People were involved in their own care planning as much as they could be, and were able to contribute to the way in which they were supported. Care planning was personalised and considered people's likes and dislikes, so that staff understood their needs fully. People were in control of their care and listened to by staff.
Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. People told us they were happy with the way that staff spoke to them, and they provided their care in a respectful and dignified manner.
The service had a complaints procedure in place. This ensured people and their relatives were able to provide feedback about their care and to help the service make improvements where required.
Quality monitoring systems and processes were in place and audits were taking place within the service to identify where improvements could be made.
The service worked in partnership with other agencies to ensure quality of care across all levels. Communication was open and honest, and improvements were highlighted and worked upon as required.