Archived: MSC Home Care Limited

Updated 10 April 2019

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.

The inspection took place on 29 August and 3 September 2018 and was unannounced. The inspection was carried out by two inspectors. There was also one Expert by Experience who made telephone calls to people and their relatives on 31 August 2018. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We looked at information we held about the service including statutory notifications submitted. Statutory notifications include information about important events which the provider is required to send us by law. We also asked Healthwatch and local commissioners if they had any information they wanted to share with us about the service. Healthwatch is an independent consumer champion, which promotes the views and experiences of people who use health and social care services. We used this information to help plan our inspection.

We spoke with seven people who used the service and five relatives. We also spoke with seven members of staff and three health and social care professionals. In addition to this we spoke with the registered manager, a director, the Business Development officer and the Nominated Individual. A Nominated Individual is someone listed from the provider who is the main contact for the CQC. We reviewed the care plans for nine people who used the service, as well as their medicine records. We looked at management records such as quality audits and the ways in which the provider monitored the service. We also looked at recruitment files for six members of staff.

Updated 10 April 2019

This unannounced inspection took place on 29 August and 3 September 2018. At our previous inspection in October 2017 the service was rated as ‘Good’ overall, with improvement required in the key question of ‘Is the service responsive?’ in relation to communication. At this inspection we found that the quality of care had deteriorated significantly and there were multiple breaches of regulation. 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, will be inspected 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 for 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.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

MSC Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and people who may have a disability or conditions such as dementia. There were 80 people using the service at the time of our inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

We found there was lack of oversight and coordination of the service and attempts to put systems in place had not been effective. Issues were not always being identified which placed people at continued risk of harm.

People did not have risks associated with their care or health conditions assessed, planned for or mitigated which left them at risk of harm. Staff did not have guidance to assist them to keep people safe at all times. We could not be assured that people were always receiving their medicines as prescribed.

Staff were not always recruited safely and staff were not always effectively deployed to ensure that everyone received their planned care. People were not always protected and lessons were not always learned as timely action was not always taken.

Staff did not always have the knowledge and skills to care for people effectively and staff had mixed feedback about the support they received. People’s rights were not protected as their capacity had not been assessed when necessary and representatives were consenting to care when their legal right to had not been verified. There was no guidance and staff did not know what to do in relation to some peoples’ health conditions. Referral were made to other health professional but timely action was not always taken to ensure this guidance was incorporated into people’s care and care plans.

Risks associated with people eating were not always considered when necessary, however some people told us they were offered a choice of food and drinks and the food was well-presented.

People did not always have a consistent team of staff which they felt impacted upon the quality of support they received. We were also told of poor conduct by some staff member which caused people and relatives upset. People were not always informed if their staff were going to be late.

There were minimal care plans in place by the service and people and relatives found the lack of guidance for staff to be a problem and meant care was not always personalised. If people raised concerns they did not always feel listened to and action was not always taken or responded to.

People, relatives and staff did not find the service to be well run and found communication to be sometimes difficult. People did not always feel they could speak to someone from the service if they needed to.

People and relatives found their individual staff kind and caring.

People were protected from the risk of cross infection as staff had personal protective equipment.

The service was not supporting anyone who required palliative care.