Merseycare Julie Ann Limited

Updated 17 February 2018

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 was 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.

This unannounced inspection was carried out on 11, 12, 13 and 14 December 2017.

At the time of our inspection the service provided personal care to approximately 700 people living in their own homes across Liverpool.

Before our inspection we reviewed the information we held about the service. This included a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at the statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the local authority to gather their feedback about the service. We used this information to plan how the inspection should be conducted.

The inspection team included three social care inspectors and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

During the inspection we spoke with 20 people who were receiving care from the service and 8 people’s relatives. Inspectors visited some people at their homes and others were contacted by telephone by the Experts by Experience. We spoke with 14 members of staff who held different roles within the service. This included the registered manager and the nominated individual. A nominated individual is a person employed as a director, manager or secretary of the organisation with responsibility for supervising the management of the regulated activity.

We looked at a range of documentation at the service’s office including 12 people’s care records, medication records, 10 staff recruitment files, staff training records, accident and incident report forms, health and safety records, safeguarding and complaints records, audits, policies and procedures and records relating to the quality checks undertaken by staff and other management records.

Updated 17 February 2018

This unannounced comprehensive inspection was carried out on 11, 12, 13 and 14 December 2017.

Merseycare Julie Ann is a domiciliary care agency. It provides personal care to approximately 700 people living in their own homes across Liverpool.

A registered manager, who had worked for the organisation for many years, was 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 last inspected the service in October 2016 and gave it an overall rating of ‘requires improvement’. On that inspection we a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that risk management plans in people’s care files were not sufficiently detailed to inform staff and some files contained conflicting information about risk.

During this inspection we found that the service had improved in this area and was no longer in breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We saw that people’s risk assessments were reviewed regularly and care files contained the information staff needed to safely manage these risks.

Medication was correctly administered and recorded by staff who had appropriate training and experience. The staff we spoke with told us that they were confident managing people’s medication and people received the right medication at the right times. The people we spoke with told us that they received their medication correctly and when they needed it.

The service had robust systems in place to protect people from abuse and staff demonstrated a good understanding of this when we spoke with them. They were able to demonstrate the actions they would take in the event of a person being at risk of harm. We saw that safeguarding concerns were promptly and effectively managed by the Safeguarding and Complaints Manager, with oversight from the registered manager.

Staff were safely recruited and were supported with an induction process. Criminal records checks, known as Disclosure and Barring Service (DBS) records, were carried out. We also saw that official identification, such as a passport or driving licence and verified references from the most recent employers were also kept in staff files.

Staff training records were up-to-date and there was a clear system to document and plan staff training. We saw that all staff had received training relevant to their roles.

All new staff took part in an induction process. This included a period of office-based training and shadowing an experienced member of staff. During the induction process staff were introduced to the people they would be visiting regularly and they were not allowed to start working on their own until their mentor had assessed them as competent to do so.

The majority of staff had received timely supervisions and appraisals. A small number of staff were not up-to-date with their supervisions but the registered manager had a plan in place to address this. We were also reassured by the fact that all staff, including staff whose supervisions were overdue, told us that they felt well-supported working for the service. They received an appropriate level of supervision and had regular contact with their line managers.

People we spoke with told us that they received care from regular staff who were caring, knew them well and whom they trusted. Some people said that sometimes alternative carers attended when their regular carers were unable to do so. They said that they preferred their regular carers but the standard of care remained good.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance available to staff in relation to the MCA. Staff demonstrated a basic understanding of this. The service was not supporting anybody under a court protection order at the time of the inspection.

Information about how to complain was available to the people using the service and their relatives. The people we spoke with told us they were confident they could voice any concerns they had. Complaints were dealt with by the service’s Safeguarding and Complaints Manager, with oversight from the registered manager, in accordance with the service’s policy and procedure and were addressed in a timely manner.

The registered provider had up-to-date policies and procedures in place to support the running of the service and these were regularly reviewed.