Mega Resources Nursing & Care - Head Office - Northamptonshire

Mega Resources Nursing & Care – Head Office - Northamptonshire is a domiciliary care service providing the regulated activity personal care, which is help with tasks related to personal hygiene and eating, in people’s own homes. At the time of our inspection 50 people were receiving personal care on a long term basis. In addition, there were 19 people receiving personal care for a short term period of up to 6 weeks, referred to as the ‘rapid response service’. The short term service supported people to regain skills, independence and confidence following discharge from hospital.

People’s experience of using this service and what we found

Systems and processes were in place to support people's safety. People's needs, including their safety were assessed and monitored. People were supported by staff who had undergone a robust recruitment process. There were sufficient staff to meet people's needs. People and family members spoke of the reliability of the service. People received the support they required with their medicines. Staff worked consistently within the providers policy and procedure for infection prevention and control.

The management team had effective systems for liaising with commissioners to facilitate people’s safe and timely discharge from hospital. People's needs were assessed and kept under review, which involved commissioners for people in receipt of short term care. People and family members contributed to the assessment process.

People's health care needs were documented, and staff liaised with family members regarding people's health and wellbeing where required. Staff had the required experience, knowledge and training to meet people's needs, which included training by health care professionals to undertake some aspects of people’s care. Staff were monitored through ongoing assessment of their knowledge and competence.

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 and family members spoke of the kind and caring approach of staff and of their involvement in decisions about their care, stating their views were respected by staff.

People and their family members were involved in the development and reviewing of their care and support package, and the care packages were tailored to reflect people's preferences. People and family members were aware of how to raise a concern, and told us they had no complaints about the service.

The provider’s systems and processes monitored the quality of the service being provided. People's views and that of family members and staff were sought through surveys, which were analysed and used to identify where improvements were needed. A range of audits were undertaken to monitor the quality of care provided. Staff were supported through ongoing monitoring and good communication, which included regular staff meetings to support the delivery of good quality care.

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 11 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance. At this inspection we found improvement had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Mega Resources Nursing & Care - Head Office - Northamptonshire is a domiciliary care agency that provides personal care to people in their own homes. At the time of the inspection they were supporting 45 people.

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

Risk assessing and care planning required some improvement to ensure people’s needs were consistently and accurately recorded. Internal systems and processes had not always identified errors in record keeping. An electronic system was being implemented at the time of the inspection to improve oversight.

People were not consistently protected from the risk of infection as not all staff were tested for COVID-19 as per government guidance. Staff had access to personal protective equipment (PPE) which was used appropriately.

The registered manager sought feedback on the service. However, people and staff did not always feel listened to when they raised concerns. Some people told us they had not received a copy of the complaints procedure after asking for a copy on a number of occasions. Some people and staff also had difficulty contacting the office team by telephone when needed.

Staff were recruited safely and there were enough staff to meet people’s needs with two staff members made available when needed. However, people and staff told us, staff were often late for care visits due to a lack of travel time between visits. We have made a recommendation that the registered manager review their rotas to ensure staff have enough travel time between care visits to promote good time keeping.

People received person centred care from staff who were kind and caring and had got to know them. People felt safe and were protected from the risk of abuse by staff who were trained and knew how and where to raise concerns.

Medicines were managed safely by staff who had received training and were competency checked by the registered manager who was a trained health professional. There were improvements required to the manager’s auditing systems to ensure errors would be picked up and corrected promptly.

Accidents and incidents were recorded and monitored, the registered manager worked with people and their relatives to prevent further incidents.

The service worked in partnership with other health care professionals such as GPs and occupational therapists.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 25 August 2018).

Why we inspected

The inspection was prompted in part due to concerns received about medicines, staffing, communication and staff attendance and time keeping. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to the quality assurance and managerial oversight of the service.

Please see the action we have told the provider to take at the end of this report.

The overall rating for the service has changed from good to requires improvement. 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 Mega Resources Nursing & Care - Head Office - Northamptonshire on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It is registered to support older people, people with dementia, younger adults and people with physical disabilities.

Not everyone using Mega Resources Nursing & Care – Head Office - Northamptonshire receives the regulated activity ‘personal care’; 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.

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.

Improvements were required to ensure that people’s care plans were sufficient in all areas, particularly with specific care needs, or regarding end of life care. The times of people’s care visits were not clear and required improving to ensure transparency and consistency.

People received safe care and staffing arrangements were flexible to meet the needs of the people that were using the service at any one time. People received support with their medicines if they wished and safeguarding incidents were given appropriate attention.

People’s needs were fully considered before they began to use the service to make sure their needs could be met. People's consent was gained before their care was provided. 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.

People were treated with dignity and respect and staff were able to get to know people by seeing the same people on a regular basis. People were encouraged to be independent and to make their own choices.

People had care plans in place which reflected their needs and these were regularly updated. Complaint procedures were in place for people to make a complaint, and these were fully investigated.

The provider had quality assurance systems in place to review the quality of the service and took action to make improvements where required. People and staff had opportunities to provide their feedback and this was fully considered and acted.