Background to this inspection
Updated
4 April 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 8 February 2018 and was announced. We gave the service 24 hours’ notice of the inspection to ensure the registered manager would be available to meet with us. The inspection team consisted of one adult social care 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. The expert by experience on this occasion had experience in providing care and support for a person living with a learning disability.
Prior to the inspection we reviewed all the information we had about the service including statutory notifications and other intelligence. We also contacted the local authority commissioning and contracts department, safeguarding, infection control, the fire and police service, environmental health, the Clinical Commissioning Group, and Healthwatch to assist us in planning the inspection. We reviewed all the information we had been provided with from third parties to fully inform our approach to inspecting this service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information was used to help inform our inspection.
During our visit to the office we spent time looking at three people’s care plans, we also looked at five records relating to staff recruitment and training, and various documents relating to the service’s quality assurance systems. We spoke with the chief executive, registered manager, a team leader and one support worker. Following the inspection we spoke with three support workers on the telephone. We also spoke on the telephone with six people who used the service and two relatives of people who used the service.
Updated
4 April 2018
The inspection of Mencap in Kirklees took place on 8 February 2018. We previously inspected the service on 20 September 2016; we rated the service Requires Improvement. The service was not in breach of the Health and Social Care Act 2008 regulations at that time.
Mencap in Kirklees is a domiciliary care agency. It provides personal care to adults with learning disabilities living in their own homes. On the day of our inspection 22 people were receiving support from Mencap in Kirklees. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service had a registered manager in place. 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.
People told us they felt safe, staff were aware of their responsibilities in the event they were concerned a person was at risk of harm. Care files contained individual risk assessments to reduce risks to people’s safety and welfare.
Staff recruitment was safe. Plans were in place to implement an electronic call monitoring system to alert office based staff in the event a person’s call had been missed. Not all staff were happy with the management of duty rotas.
People’s medicines were only administered by staff with the knowledge and skills to do so. All medicine administration records were routinely audited on return to the office to enable any concerns to be addressed promptly. Where people were prescribed medicines to be taken ‘as required’ (PRN) there were no directions for staff as to how to ensure their administration was safe and consistent. The registered manager assured us action would be taken to address this shortfall.
New staff received induction and there was a system in place to ensure staff received regular training. Staff had completed the theory aspect of the Care Certificate but the field based assessment of their competency had not always been completed. Staff had not received regular management supervision and there was no system to ensure all staff had received a regular field based performance assessment.
People received support with meals and drinks. Care plans recorded the support people needed with this aspect of their lives.
Staff were aware of how to access additional healthcare support for people and we saw evidence of this within peoples care files.
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. We saw evidence people had given their consent to the care and support they were receiving.
Staff were caring and kind. People’s right to privacy was respected and staff treated people with dignity. People were encouraged to retain their independence and complete tasks with staff support. People and their relatives were involved in their care plan and this was evident in the care plans we reviewed. Staff enabled people to make their own choices and decisions, implementing other methods of communication where people’s verbal skills were limited.
Staff supported people to engage in activities which interested them.
Care plans were person-centred and contained relevant information to enable staff to deliver peoples care. Where people may present behaviour which may challenge others, we saw care plans recorded how the behaviour was displayed and the actions staff should take to defuse the behaviour.
People did not raise any complaints with us and information about how to raise a complaint about the service was easily accessible for people who used the service.
There was a system of governance in place. The group manager completed an audit of the service and action plan was implemented to address any identified shortfalls. The organisation had recently achieved external accreditation regarding their management systems. Feedback was gained from people who used the service and staff on a regular basis. This information was included in an annual performance report which was shared with people, their relatives and staff.