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Morecare Services(UK)Ltd Requires improvement

Reports


Inspection carried out on 28 January 2021

During an inspection looking at part of the service

About the service

Morecare Services (UK) Ltd is a domiciliary care agency. It provides support and personal care to people living in their own homes. The agency supported 38 people at the time of our inspection.

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

The provider had not always recruited staff safely. Two staff about whom safeguarding concerns were raised were found to have provided false documentation when they joined the agency, which had not been identified through robust checking and verification.

The provider had not always provided information in good time when safeguarding concerns were investigated. In safeguarding investigations involving members of the agency’s staff in 2020, there was a considerable delay in the provision of information, which hampered the investigations and addressing any concerns identified.

People did not always receive consistent, well-planned care. Some people were happy with the service they received. They told us staff timekeeping was good and that they saw the same care workers regularly. People who saw the same staff regularly were happy with the support they received. They told us they felt safe with the care workers who supported them and said staff understood their needs.

However, other people said staff were often late for their calls and they saw a number of different care workers. People told us late calls meant they had to wait for aspects of their care, such as meals, and could not plan their day. Some people said frequent changes of care workers affected their experience of care because staff did not know their needs well.

People’s experience of communication from the agency was also variable. Some people told us the agency was flexible if they requested changes and kept them informed about any changes to the staffing rota. Other people told us the agency did not communicate important information to them, such as changes to their regular care worker or if staff were running late.

People told us staff wore appropriate personal protective equipment (PPE) when they visited their homes and provided their care. Since our last inspection, the provider had improved the management oversight and auditing of medicines.

Staff told us they were well supported by the agency’s management team. They said support was available to them when they needed it and that they had regular one-to-one supervision online. Team meetings also took place online. Staff told us these were used to keep them up to date about people’s needs and their working practices, such as government guidance regarding COVID-19.

Rating at last inspection and update:

The last rating for this service was requires improvement (published 1 April 2019) and a breach of regulation was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

We carried out an announced inspection of this service on 18 January 2019. A breach of legal requirements was found in relation to of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

We undertook this focused inspection to check the provider 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 remained 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 Morecare Services (UK) Ltd on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This me

Inspection carried out on 18 January 2019

During a routine inspection

The inspection took place on 18 January 2019 and was announced.

The last inspection of the agency was on 12 January 2018 when we identified no concerns and rated the service Good.

This service is a domiciliary care agency. It provides support and personal care to people living in their own homes. The agency supported 61 people at the time of our inspection.

There was no registered manager in place at the time of our inspection. 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. The agency’s manager was able to demonstrate that they had submitted an application for registration with CQC.

Safeguarding concerns had been raised by professionals about the agency in the latter half of 2018 and in January 2019. Some care calls had been missed and the agency had taken on a care package that it was unable to meet. There were also concerns about some aspects of care provision.

The agency had investigated these concerns when required to do so by the local authority and shared the results of its findings. However, the provider had not notified CQC of these concerns at the time they occurred, which meant the provider had not met their statutory obligations.

We found that some of the concerns had arisen because the provider’s management systems were not sufficiently robust to cope with an increase in the number of people using the agency. For example, records and call monitoring systems were in paper rather than electronic form, which meant the provider was not always aware of issues as soon as they occurred.

The provider had implemented some measures to address the issues highlighted by the safeguarding concerns, such as moving to an app-based call monitoring system, although we have made a recommendation that the provider further improve the monitoring of people’s medicines.

The feedback we received from people and their relatives indicated that staff infection control practice and their knowledge of people’s needs was good. People told us staff kept their homes clean and used gloves and aprons when necessary. Staff reported that they had attended training in infection control and always had access to supplies of personal protective equipment.

The agency carried out assessments to ensure that staff had the skills they needed to provide people’s care. Care plans were developed from these assessments, which provided guidance for staff about how to provide people’s care. However, there were no specific end-of-life care plans in place for people receiving this care. We made a recommendation about this.

People said they received their care from regular staff who knew their needs well. They told us staff had the skills they needed to provide their care in a safe way. Staff received the induction, training and support required to carry out their roles. Staff gave positive feedback about the training and support they received and said they were encouraged to obtain further relevant qualifications.

The registered provider made appropriate checks on staff before they started work to ensure they were suitable for their roles. Staff attended safeguarding training and knew how to report any concerns they had about people’s safety or wellbeing. Staff who had reported concerns gave us examples of how people’s care had improved as a result.

People’s care was provided in accordance with the Mental Capacity Act 2005 (MCA). Staff sought people’s consent before providing their care and people told us staff respected their decisions about their care. People’s nutritional needs were assessed and any dietary needs recorded in their care plans. Staff understood people’s healthcare needs and supported them to maintain good health.

Staff were kind and caring. Peo

Inspection carried out on 12 January 2018

During a routine inspection

The inspection took place on 12 January 2018 and was announced.

Morecare Services (UK) Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and younger disabled adults. The agency provided personal care to 30 people at the time the Director submitted the Provider Information Return (PIR) on 8 December 2017. Twenty-seven care packages were funded by local authorities, two by the local Clinical Commissioning Group for continuing healthcare and one privately funded. The agency did not provide any live-in care at the time of our inspection.

There was no registered manager in place at the time of our inspection. 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. The previous registered manager had left the agency in September 2017. The agency’s Director had applied for registration with the CQC but had withdrawn their application. We were advised during the inspection that one of the agency’s care co-ordinators would apply to be the registered manager of the agency.

At the last inspection on 12 November 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

Staff provided people’s care in a safe way. They understood the risks involved in people’s care and managed these safely. The rota was planned to ensure there were sufficient staff to keep people safe and meet their needs. People could rely on the agency’s staff and said their care workers had never missed a visit. They told us staff almost always arrived on time and that they were informed if staff were running late.

The providers’ recruitment procedures helped ensure the agency employed only suitable staff. Staff attended safeguarding training and understood their responsibilities in terms of keeping people safe and protecting them from abuse. The provider had developed a contingency plan which prioritised the delivery of care to people most at risk in the event of an emergency. Where people received support with their medicines, this was managed safely. People were protected against the risk of infection because staff helped keep their homes clean and hygienic.

People’s needs were assessed before they used the service to ensure the agency could provide the care they needed. People were confident that their care workers had the skills they needed to provide their care. They said staff knew how their care should be delivered and were well trained to do their jobs. Staff told us they had access to the training they needed to provide people’s care. Training records confirmed this and that staff had access to any additional training they needed to meet the specific needs of the people they cared for.

People received their care from a consistent team of staff, which they said was important to them. People’s care was provided in accordance with the Mental Capacity Act 2005 (MCA). Staff had received training in this area and how the principles of the Act applied in their work. People were asked to record their agreement to their care plan and confirm their consent to the care being provided.

People’s nutritional needs were assessed during their initial assessment and any dietary needs recorded in their care plans. Where people needed assistance with eating and drinking there was a care plan in place to outline the support they required. Staff understood people’s healthcare needs and supported them to maintain good health.

People reported that the staff who supported them were kind and caring. They said they had positive relationships with staff and enjoyed their company. Relatives said staff treated their family members with respect and mainta

Inspection carried out on 12 November 2015

During a routine inspection

The inspection took place on 12 November 2015 and was announced.

Morecare Services (UK) Ltd. provides personal care for people in their own homes. There were four people using the service at the time of our inspection and the agency employed nine care workers.

There was no registered manager in post at the time of our inspection. The manager had submitted an applicaton for registration with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

Staff attended safeguarding training and were made aware of the provider’s whistle-blowing policy, which clarified their responsibilities should they suspect abuse was taking place. The agency took appropriate steps to keep people’s property secure. The agency ensured that information about how to access people’s homes was kept safe and only available to those who needed to know.

People were protected by the provider’s recruitment procedures. The provider carried out pre-employment checks to ensure they employed suitable people to work at the agency. People were supported by competent staff who had access to the training and support they needed. Staff had received training in safe medicines management and in the use of any specialist equipment or adaptations involved in the delivery of people’s care.

Relatives told us their family members received their care from regular care workers who knew their needs well. People said their care workers were kind and caring and that they had developed positive relationships with their care workers. They told us their care workers almost always arrived on time and stayed for the length of time required to ensure all their needs were met.

People’s needs were assessed before they began to use the service and an individual care plan drawn up from their assessment. Care plans reflected people’s individual needs and preferences and provided clear information for staff about how to provide appropriate care and support. The agency’s Director carried out spot checks to ensure that care workers delivered care in line with people’s care plans and supported people in a way that maintained their safety and dignity.

The provider had a complaints policy which set out the process for dealing with complaints. People were supported to have their say about the care they received and relatives were encouraged to contribute their views. People told us the agency contacted them regularly to seek their feedback and said the agency had responded appropriately if they had requested changes to the care provided.

People told us the agency was efficiently managed. They said they had always been able to contact the office when they needed to and that the agency communicated well with them. Staff told us they felt supported by the agency’s Director and the manager and that out-of-hours support was available if they needed it.

The agency had established systems of quality monitoring which included seeking feedback about the service from people and their relatives. The records we checked in the agency’s office relating to people’s care were accurate, up to date and stored appropriately.

The last inspection of the service took place on 19 December 2013 and there were no concerns identified.

Inspection carried out on 19 December 2013

During a routine inspection

MoreCare Services (UK) Ltd provides domiciliary care services to people who live in their own homes. At the time of our visit we were informed that there were five people using their service. People�s care packages were tailored to people�s needs, which varied from living in services to visiting support up to four times a day.

During our visit to the MoreCare's office we looked at records which included care files of people who use the service, personal files of employees and information the provider used to assess and monitor the quality of the service. We visited the homes of two people and spoke with a relative. During the home visits we were able to observe how staff interacted with people. We saw staff treat people in a sensitive, respectful and professional manner.

People told us that they were happy with the support they received and that the staff were very good. One person told us that they felt �very safe� and that the staff were �very kind and friendly�. A relative told us that staff visit three times a day and that the staff were very good, and treated the person with dignity and respect. The relative also told us that when it was the person�s birthday that staff had sung �happy birthday� which they all enjoyed.

We saw that care plans were person centred and people's care needs were reviewed. We found that MoreCare had processes in place to regularly monitor the quality of the service.

Inspection carried out on 28 January 2013

During a routine inspection

When we inspected the service there were two people who received personal care services from MoreCare.

We spoke with one person and one relative of a person who used the service and asked them what it had been like to have received services from MoreCare. Both people were positive about the service they or their relative had received.

People we spoke with told us that they were treated with dignity and respect. We were told that people were fully involved in decisions about their care and were able to make choices about their care and support.

People were aware of their care plan and confirmed that they knew where it was and that staff would always write in it when they visited. We were told that staff were kind and that people felt safe with the staff.

We reviewed staff records and spoke with staff. There were four staff, which included the manager and deputy manager and they were in the process of recruiting more staff.

People expressed satisfaction with the quality of the care being provided. People told us that they were asked to comment on the quality of the service and one person told us that MoreCare �Offer a very good service.�