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Archived: My Care Direct Requires improvement Also known as My Care Direct

Inspection Summary


Overall summary & rating

Requires improvement

Updated 16 June 2016

The inspection took place over two days, 26 February and 2 March 2016. We announced the first visit a day in advance because this is a small service and we wanted to ensure someone would be present in the office. This was the first inspection of the service.

My Care Direct provides a service to people in their own homes. It has a contract with Trafford Council to provide care for people after they have had re-enablement and/or following a stay in hospital. In most cases the service provides care for a short period of weeks or a few months at most. At the date of this inspection there were 15 people using the service in this way. My Care Direct was supporting a further six people with shopping and cleaning and other related services.

There is a registered manager who has been in post since January 2015. 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 that they felt safe receiving the service. They told us they could rely on their care workers to arrive on time, or to contact them if they were running late. There were a few examples of late or missed calls, but we received explanations of why these had happened and the actions taken to prevent a recurrence.

Staff received rotas in advance and any changes were notified to them. One member of staff told us that 15 minute calls were not always long enough, for example if they had to make and serve a meal. No person receiving the service told us that the calls were too short. Care workers logged in and out using their own mobile phones, but the system did not currently alert the office if a care worker had not arrived.

All staff were trained in safeguarding and in moving and handling in order to keep people safe. We saw that people’s safety and the safety of staff were both high priorities.

Records were kept of medicines for those people where My Care Direct assisted people. The registered manager told us the accuracy of these records was important. Staff had recently received training on medicines administration.

Correct processes were followed to explore the background of new members of staff and ensure they were suitable to work with vulnerable people.

We saw there was a high rate of completion of training in all mandatory topics. New staff had all received induction training in those areas. Staff told us they found the training worthwhile. New staff were also doing the Care Certificate, a new set of standards for care workers. Not all staff had been trained in understanding the Mental Capacity Act 2005.

People using the service gave positive feedback about the standard of training, except in one case where a relative told us the care worker had not been trained to use a particular type of catheter bag.

The fact that some staff had not been trained in the Mental Capacity Act 2005, and the example of a member of staff not having received sufficient training in catheter care, were a breach of the Regulation relating to the appropriate training of staff.

Staff received regular supervision. Spot checks were conducted on new staff. The registered manager was introducing annual appraisals, although most of the staff had worked less than one year.

The registered manager showed a good knowledge of the Mental Capacity Act 2005 but had not conducted any mental capacity assessments. This meant there was a risk that some people’s needs might not be assessed. This was a breach of the Regulation relating to the need for obtaining in consent in line with the Mental Capacity Act 2005.

Where care workers prepared food people were satisfied. Care workers recorded food intake when it was important to do so. People told us that their care workers were kind and pleasant. They said that

Inspection areas

Safe

Good

Updated 16 June 2016

The service was safe.

People received a reliable service with very few late or missed calls. When there was a late or missed call it was investigated and action taken to stop it happening again.

The service ensured that staff knew what calls they were making so that calls would not be missed.

Staff were trained in safeguarding and in assisting people to receive medicines. Proper procedures were followed to recruit suitable staff.

Effective

Requires improvement

Updated 16 June 2016

The service was not always effective.

Staff had received induction training. Not all staff had received training in the Mental Capacity Act 2005. A lack of training in catheter care had caused a problem on one occasion.

The registered manager was not conducting mental capacity assessments which meant the service was not working within the principles of the Mental Capacity Act 2005.

The registered manager conducted spot checks on new staff and regular supervision sessions.

Caring

Good

Updated 16 June 2016

The service was caring.

People said they were treated with dignity and respect, and gave positive feedback about the care they had received.

Care workers built up friendly caring relationships with the people receiving the service. They encouraged them to regain independence.

People told us that staff always asked them what they wanted doing.

Responsive

Requires improvement

Updated 16 June 2016

The service was not always responsive.

Care plans were often based on plans supplied by Trafford Council. They provided adequate information about the care needs of people receiving the service. People were not always involved in the development of their care plans.

Care plans were reviewed by the registered manager who visited each person as part of the review.

A record was kept of complaints and lessons were learned from them. One complaint had not been recorded as a formal complaint but should have been. Some of the complaints policies were incorrect.

Well-led

Requires improvement

Updated 16 June 2016

The service was not always well led.

The registered manager worked without office support. She was able to complete the tasks as the service was small. The office was not manned if the registered manager had to leave it.

There were regular staff meetings which helped to engage staff in the running of the business. Surveys of people using the service did not reach enough people.

The registered manager conducted audits. Care plan audits were recorded on the care files but there was no separate list of which audits had been done or of actions taken as a result. Governance systems needed to be more robust.