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Heart of England Mencap DCA Central Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 14 November 2019

About the service: Heart of England Mencap DCA Central is registered as a domiciliary care service which provides personal care to people in their own homes and within supported living accommodation. It also provides personal care to people living within extra care settings. At the time of our inspection 60 people were being supported with personal care.

People’s experience of using this service:

Staff understood how to keep people safe and how to report any concerns they may have. However, under previous management, safeguarding concerns had not always been acted on in a timely way.

Staff had been trained in administering medication, however a lack of oversight meant we could not be assured people were receiving medication as prescribed.

People’s capacity to make important decisions had not been assessed where required.

Risks to people had been identified but it was not always clear how risks had been assessed and action was not always taken to mitigate risk in a timely way.

Despite this, staff knew about risks associated with people’s health and understood how to minimise these as they knew people well.

There were enough staff to meet people’s physical and emotional needs.

Staff were recruited safely, and processes checked the background of potential new staff.

Accidents had been recorded and any immediate action had been taken to reduce the risk of the event happening again. Overall analysis was complete to identify patterns and trends.

Staff understood how to prevent the spread of infection.

People’s needs were assessed before being supported by the service.

Staff received an extensive induction and had access to the training and guidance they needed to complete their role well.

People were offered choices. For example, in the meals and drinks they were offered.

Staff respected people’s rights to privacy and dignity.

Every person and relative we spoke to told us staff were caring and kind.

Staff treated people with dignity and respect.

Care plans were personalised and contained the information and guidance staff needed to support people to achieve their goals and aspirations.

Systems were in place to manage and respond to any complaints or concerns raised.

The manager had systems and processes to monitor quality within the home. However, these had not yet been embedded.

The Chief Executive was open and transparent about the difficulties they had faced over the past 12 months and had recently changed the management structure at the service to ensure the quality of service delivery was improved.

The new manager understood their regulatory responsibilities and had informed us of significant events at the service since taking on the management role.

Lessons had been learned when things went wrong.

Rating at last inspection: Good. (The last report was published on 10 August 2016).

Why we inspected: This was a planned inspection to confirm that the service remained Good. The service is now rated ‘Requires Improvement’.

The registered provider was in breach of Regulations 11 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Enforcement: Action we told provider to take (refer to end of full report).

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at

Inspection areas


Requires improvement

Updated 14 November 2019

The service was not always safe

Details are in our Safe findings below.


Requires improvement

Updated 14 November 2019

The service was not always effective

Details are in our Effective findings below.



Updated 14 November 2019

The service was caring

Details are in our Caring findings below.



Updated 14 November 2019

The service was responsive

Details are in our Responsive findings below.


Requires improvement

Updated 14 November 2019

The service was not always well-led

Details are in our Well-Led findings below.