Archived: Care Matters Teesside (Homecare) Limited

Care Matters Teesside (Homecare) Limited is a domiciliary care service providing personal care to people in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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. At the time of the inspection 190 people received the service.

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

Pre-employment checks ensured suitable staff were employed. Any identified risks were managed with decisions recorded. People felt safe with the staff who provided their care.

People had received assessments of their needs to ensure the service was suitable. Records included associated information where known risks were evident. Staff used this information to provide safe care for people, and to ensure they remained safe whilst in people’s homes.

People were protected from known risks from infection. This included those associated with Coronavirus. Routine infection prevention and control practices had been reviewed and updated. Staff clearly understood when and where to wear personal protective equipment.

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 their relatives spoke positively about the personal care they received. People received their care and support from regular staff who understood their needs. Checks were completed to ensure people were happy with the staff who visited, and the service provided.

Staff received safeguarding training and were clear on how and when to raise their concerns. The provider had embedded systems and processes which were followed to investigate any concerns. Where appropriate, actions were implemented to keep people safe.

People confirmed they received their medicines from suitably skilled staff, safely as prescribed. Medicines records were maintained, and associated checks completed. An action plan was in place to review the medicine audits to ensure any required actions were clearly documented.

The provider had implemented a range of checks to maintain and improve standards of service. Where areas of improvement were identified, action plans were in place and reviewed for their effectiveness.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 January 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection improvements had been made and the provider was no longer in breach of regulation.

Why we inspected

This was a planned inspection based on the previous rating

We carried out an announced inspection of this service on 9 and 10 January 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in 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 Safe 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 Care Matters Teesside (Homecare) Limited on our website at www.cqc.org.uk.

Follow up

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.

Care Matters 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 children, younger and older adults. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection they were 136 people receiving personal care.

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

Overall the feedback we received from people and relatives was complimentary. However, we found continued concerns about the aspects of managing risks, medicine records and the governance of the service. Although there had been some improvements, legal requirements were still not consistently met.

Risks associated with people’s care continued to not always be detailed in their care plans, which meant staff may not always know how to support them safely and with continuity. One person had a specific care need and external healthcare professionals (HCP) had detailed how this need was to be carried out. The person’s care plan did not record these specific details, however, staff we spoke to were following the HCPs record rather than the care plan, which meant this was more down to records rather than unsafe practice and we found no evidence that people had come to harm.

People told us they felt safe when staff entered their homes and said the care workers generally arrived on time. Staff were knowledgeable about what action to take if they suspected someone was being abused, mistreated or neglected. The provider had a system in place for auditing and monitoring accidents and incidents.

Staff had received training to understand how to support people well. Staff felt supported in their role and received regular supervisions and spot checks.

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; systems supported this practice. The registered manager ensured care was based upon good practice guidance to help ensure people received an effective service.

People said the care workers were very caring. One person said, “I think the carers are very optimistic, jolly and very caring in nature when they see me.”

Care records provided information in relation to people's backgrounds, interests and care needs. People were provided with information in a way they could understand. Complaints were fully investigated with an outcome.

People said they would recommend Care Matters to other people. One person said, “Care Matters have proved effective in the time I’ve used them, and I would be confident in continuing to use the service even if my care needs increase.”

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 23 February 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvements had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Enforcement

We have identified breaches in relation to the management of risk, records and governance.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

Care Matters Teeside (Homecare) Limited is a domiciliary care agency. It provides personal care to people living in their own houses. All 46 of the people supported by the service at the time of the inspection received support with their personal care.

The service had a registered manager. The registered manager had been in post since September 2018. A registered manager is a person who has registered with the Care Quality Commission to manager 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.

This was the first inspection of the service since it registered with the Care Quality Commission (CQC) in July 2018.

We found that some risks to individuals were documented but information was missing or contradictory around other risks. People’s plans of support did not always contain accurate up to date information. Support plans required review as some information was missing and some of the information recorded was contradictory.

We identified some gaps in medicine records and a lack of information relating to people’s health conditions.

The registered manager had implemented some quality assurance checks however these were not yet robust and required further development. Whilst accidents and incidents were recorded there was no evidence of a system in place for analysing these to identify any themes and trends.

We identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to good governance.

You can see what action we told the provider to take at the back of the full version of this report.

We found that staff members knowledge of safeguarding was variable and they had not all received safeguarding training. However, this had been scheduled to take place.

People told us that staff sought consent before carrying out tasks with them. 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. However, staff did not receive any specific training in the Mental Capacity Act 2005 (MCA) and some staff lacked knowledge of the actions to be taken if a person lacked capacity to make a decision for themselves. We have made a recommendation about staff training on the MCA to improve their knowledge.

Records showed that people’s relatives signed some plans of support when there was no evidence available that they had the legal authority to do this.

Recruitment policies minimised the risk of unsuitable staff being employed and checks were carried out before staff commenced work. However, we found that there were some gaps in recruitment records related to references. This had been identified and was being addressed by the registered manager.

Sufficient staff were employed to meet people’s needs. Staff were supported through their induction and had regular supervision meetings.

Staff did not always show an up to date knowledge of people’s nutritional needs and information relating to these was not always available in people’s files.

People’s needs were assessed on admittance to the service. The registered manager told us they had recently developed an improved pre-admission assessment to ensure people’s needs could be met fully prior to their support from the service commencing.

Staff supported people to maintain their health and access healthcare services when needed. Most people and their relatives told us that staff were kind and caring and promoted their dignity. Feedback from people, relatives and staff about the service had been sought and was generally positive.

Staff told us how they respected people’s rights and maintained their privacy. People and relatives told us staff were very respectful. Further information needed adding to some care files to ensure all support plans were person centred.

People and their relatives told us they knew how to complain. A complaints policy and procedure was in place. Complaints that had been received had been managed appropriately.

Staff knew how to support people with end of life care in a compassionate way.

Infection control policies and procedures were followed to support the control of infection.

Contingency plans were in place to ensure people’s needs could be met in the event of an adverse incident.

The people and the staff we spoke with were positive about the leadership and management of the service. The service was working in partnership with other agencies to meet people’s needs.

This is the first time that the service has been rated as Requires Improvement