We carried out a review of the data available to us about Multilink Management Care Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Multilink Management Care Ltd, you can give feedback on this service.
Multilink Management Care Ltd is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 15 people were supported with their personal care needs.
Not everyone who used the service received personal care. 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.
People’s experience of using this service and what we found
At our previous inspection in October 2020, we found that effective systems were not being used to monitor the quality of care being provided and safely recruit staff. However, during this inspection, we found the provider had acted on our feedback and implemented their action plan and the regulatory requirements were being met. There was significant improvement to the providers systems to safely manage people’s care and the management and recruitment of staff.
The registered manager had ensured that each person’s care needs had been comprehensively reviewed. People’s support requirements were reflected in their care plans to help guide staff on the actions they should take to help mitigate people’s personal risks. People’s care records were detailed, accurate and reflected their preferences, risks and required support.
Medicines care plans outlined the agreed management of people’s prescribed medicines and creams. Safe infection control practices were used, and staff wore the correct personal protective equipment when they entered people’s homes and supported them with their personal hygiene needs.
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.
Systems to safely recruit staff had been reviewed and implemented. People were supported by sufficient numbers of staff who had been vetted and assessed as being of good character and competent before they provided care to people.
The registered manager sought feedback about people’s experiences of the service. They worked in partnership with people’s families and health care professionals to achieve good outcomes for people.
Quality assurance systems had been reviewed and developed to assist the register manager in monitoring the quality of care being provided and the management and training of staff.
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 4 December 2020) and there were multiple 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 we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating. This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We carried out an announced focused inspection of this service on 8 October 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 safe care and treatment, fit proper person employed 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 Multilink Management Care Ltd 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
Multilink Management Care Ltd is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 17 people were supported with their personal care needs.
People’s experience of using this service and what we found
Some improvements had been made to the service since our last inspection in November 2020, however the provider’s action plan had not been effective in addressing the shortfalls in relation to safe care, recruitment and quality monitoring we found at our previous inspection. People may be at risk as the service continued not to meet all the regulatory requirements.
Systems to monitor the quality and safety of the service were ineffective and had not identified the concerns we found in relation to people’s risks and medicines management, assessment of staff knowledge and staff recruitment prior to our inspection. Whilst the registered manager delivered care and had some oversight of the service, they had failed to ensure people received a well-managed service which was safe.
Risk assessments were not robust enough and did not contain enough information of the actions to take to minimise risks to people and to direct staff in how people should be supported. Clear medicines management records were not in place for some people. Staff we spoke with told us they understood their roles and responsibilities and felt supported by the registered manager. However, staff had not always received up to date training to ensure they could always provide safe care. Systems to support staff in their induction and probation period had not been completed.
Robust recruitment systems were still not effectively used to ensure people were supported by staff of good character.
People and relatives, we spoke with said they felt safe when staff visited them and had no concerns about the care and support, they received. People were supported by staff who were familiar with their needs, however some people felt staff could be more punctual as they sometimes arrived late which impacted on their care and well-being.
Spot checks and observations of staff visits in people's homes were carried out but not always recorded. This meant that the provider could not be sure staff were supporting people as they wished and meeting their support needs.
People reported that staff has good infection control practices and wore the appropriate PPE.
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 31 December 2019) and there were multiple 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 enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 15 and 20 November 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, fit and proper persons employed 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 ‘Is the service 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 Multilink Management Care 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 meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified repeated breaches in relation to safe care and treatment, fit and proper person’s employed and governance at this inspection.
Where we are taking or proposing to take enforcement action but cannot yet publish the actions due to representation and appeals process the text below must be added under this heading
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.
Multilink Management Care Ltd is a is a domiciliary care agency providing personal care in people's own homes. At the time of the inspection the service was providing care and support to 10 people. Not everyone who used the service received personal care. 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.
People’s experience of using this service and what we found
Multilink Management Care Ltd registered with CQC in March 2018. Since registration, the registered manager had concentrated on building up a service and delivering care to people. At the time of the inspection, the registered manager monitored the care people received through feedback from people and observations of staff care practices. However further quality assurance checks were needed to ensure the service fully complied with legal requirements. Staff did not have access to comprehensive records of people’s care and risk management plans to guide them in the best ways to support people and assist in mitigating people’s risks. End of life care plans had not been put in place for those who required palliative care.
The registered manager had not always ensured fit and proper staff had been employed to provide the regulated activity of personal care. Staff told us they felt trained and supported, however the registered manager was unable to demonstrate that they had assessed and monitored staff practises and competencies and provided regular supervision in line with their staff management policies.
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. However, the assessment and outcome of people’s mental capacity to consent to their care and support had not been implemented and completed using the principles of the Mental Capacity Act (2005).
People were supported by a small staff team who were familiar with their needs. They told us staff arrived on time and communicated when they were running late. People confirmed they received personalised care which was responsive to their needs. They all complimented the staff and told us staff were kind and always respectful and polite. Staff promoted people’s independence and always cared for people with dignity and respect.
Staff were aware of their responsibilities to record and report any concerns of abuse, accidents, incidents and near misses. People’s complaints had been investigated and acted on. Staff worked closely with people’s relatives to monitor people’s well-being and had referred people to appropriate health care services when their needs had changed
The registered manager was passionate about delivering good quality care to people. They were open to learning and making improvements to the service. People and staff complimented the registered manager and told us they were approachable and very kind. People’s feedback and complaints were acted on and seen as an opportunity to learn and drive improvement.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This service was registered with us on 26 March 2019 and this is the first inspection.
Enforcement
We have identified breaches in relation to the monitoring of the service, management of people’s risks, the recruitment of staff and records of people’s care and staff performance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. 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.