Archived: Manchester Services Limited

Manchester Services Limited (also known as CRG and Cera Manchester) is a domiciliary care service providing personal care to people living in their own homes. The service provides support to older people, people living with dementia, learning disabilities and autistic spectrum disorder, mental health, physical disability and sensory impairment. At the time of our inspection there were 214 people using the service.

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

The poor planning of visit times impacted on people’s health and wellbeing and put people at risk of the unsafe management of medicines, skin integrity and nutritional care. There was a lack of consistency in staffing and the provider relied on agency workers who did not receive an induction to the service.

Missed visits were a regular occurrence.

People did not receive the commissioned times of care and support. Staff told us they didn’t have time to stay for the entire visit and there was not enough travel time. Staff said they would often find their rota changed and have to travel long distances or get taxis to try and reduce the impact on people’s visiting times.

There was a lack of oversight from the provider and governance arrangements were not clear. There was a lack of understanding about risks and issues across the service. Concerns and complaints were not always responded to and staff did not feel supported or have the direction they needed to support people appropriately. Staff were not receiving regular supervision and competency checks.

Staff did not always have access to information to enable them to effectively support people. People were not able to review their care plans and some people did not feel involved in planning their care. People were not always informed which staff members would be visiting them and choice of carer gender was not always respected.

People did not know the name of the agency supporting them due to merging with other agencies and subsequent name changes. Staff were confused of what processes they were following due to the number of changes and differing paperwork and policies being in use.

People didn’t always feel they were treated with kindness and respect and there was a lack of a dignified response from the office staff. Communication across the service was lacking and it was evident from speaking with people and their relatives, the lack of communication was causing distress.

People were not supported to have maximum choice and control of their lives. Care records were not clear in relation to how people who lacked capacity were consenting to care and treatment; the policies and systems in the service did not support this practice.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

This service was registered with us on 28 September 2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and the timeliness of visits to people to deliver personal care and support. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

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 will take further action if needed.

We have identified breaches in relation to person centred care, safe care and treatment, good governance and staffing at this 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.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.