Archived: Manchester

Manchester is a domiciliary care service based in Salford and provides care to people within their own homes, predominantly in the Trafford area of Greater Manchester. The service is operated by Olive Healthcare Solutions Limited and their headquarters are based in Mansfield.

Rating at last inspection:

Our last inspection of Manchester was in August 2018. The overall rating at this inspection was inadequate, including the key questions safe and well-led, and the service was placed into special measures. This also resulted in the local authority no longer offering new packages of care to the service until standards improved.

At the August 2018 inspection we identified regulatory breaches in relation to safeguarding people who used the service from abuse and improper treatment, receiving and acting on complaints, fit and proper persons employed and staffing. We also issued two warning notices relating to safe care and treatment and good governance. The service then sent us an action plan, telling us how they intended to improve to meet regulatory requirements.

People’s experience of using this service at this inspection:

We carried out this comprehensive inspection on 14 and 19 March 2019. At the time of the inspection there were five people using the service.

We found the service had improved in all areas since our last inspection and this was reflected in the feedback we received from both people who used the service and their relatives.

People said they felt as a result of the care they received, with staff demonstrating a good understanding about how to protect people from the risk of harm.

Staff were recruited safely, with appropriate checks carried out to ensure there were no risks presented to people using the service.

There were enough staff to care for people safely and people told us staff always arrived to deliver their care. When staff were going to be late they were kept informed by the service.

People received their medication as prescribed.

Staff received the appropriate induction, training and supervision to support them in their role.

People received the support they required to eat and drink at meal times.

People who used the service and their relatives made positive comments about the care provided. The feedback we received from people we spoke with was that staff were kind and caring in their approach.

People said they felt they were treated with dignity and respect and that staff promoted their independence as required.

Complaints were handled appropriately, with an appropriate complaints system now in place.

Appropriate systems were now in place to monitor the quality of service being provided, with a number of audits, spot checks and competency assessments used to check the quality of service being provided.

We have made a recommendation for the service to develop more community links within the local area.

We received positive feedback from everybody we spoke with about management and leadership within the service. Staff said they felt supported and could approach the registered with any concerns they had about their work.

More information is in the detailed findings below.

Why we inspected:

This inspection was carried out to check if standards of care had improved since we last inspected the service in August 2018 when regulatory requirements were not being adhered to. The inspection was also to check that the two warning notices regarding safe care and treatment and good governance had been met.

Follow up:

We will continue to monitor information and intelligence we receive about the service to ensure good quality care is provided to people. We will return to re-inspect in line with our inspection timescales for ‘Good’ rated services, however if any further information of concern is received, we may inspect sooner.

We undertook this inspection on Tuesday 14 and Thursday 16 August 2018. This was the first comprehensive inspection we had undertaken of the service, since registering with CQC in December 2017.

At the time of the inspection there were 27 people using the service.

At this inspection we found six breaches of the Health and Social Care Act 2008 (Regulated Activities) relating to safe care and treatment, safeguarding people from abuse and improper treatment, receiving and acting on complaints, good governance, staffing and fit and proper persons employed.

You can see what action we have asked the service to take at the end of this report.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special Measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, we will be inspecting again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate in any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

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.

Medication was not handled safely and people did not always receive their medicines as prescribed.

Appropriate recruitment checks were not in place and staff were not always recruited in line with the recruitment policy and procedure.

Safeguarding concerns were not always reported to the local authority for further investigation such as when people were found with unexplained bruising.

Records of any accidents and incidents were maintained, however the forms lacked detail about actions to take to prevent future re-occurrence.

There were enough staff working for the service, however people who used the service and relatives said they would like to be informed when staff were running late for a care call.

The staff induction programme was not based around the care certificate. Staff who had not worked in a care role previously had not been able to complete this when they first commenced their employment.

Staff did not receive regular supervision and appraisal.

Overall we received positive comments about the care provided, however due to the wider concerns identified during the inspection people who used the service did not always benefit from a caring culture.

The service did not have systems in place to record and respond to complaints. Several relatives told us they had voiced concerns with the office, however these had not been logged and we were unable to see how they had been acted upon.

A range of policies and procedures were in place, however they were not always being followed.

Quality assurance systems were not effective in identifying concerns from this inspection and a number of audits and checks had not been carried out. Audits were not undertaken at provider level to monitor the work carried out at this branch.

Spot checks and observations of staff had not been undertaken so that managers could monitor and provide feedback about staff practice when providing care in people’s homes.

Competency assessments had not been carried out in a number of key areas such as moving and handling and medication.

Statutory notifications were not always being submitted to CQC when required, such as when safeguarding incidents had occurred.

People who used the service said they felt safe and staff understood their role with regards to safeguarding and whistleblowing procedures.

Staff received a range of training to support them in their role.

People received enough to eat and drink and said they were assisted as required by staff.

There were systems in place to seek feedback about the quality of service being provided through satisfaction surveys.

People were supported to access the local community by staff.