Archived: Mears Care London West

Mears Care London West is a domiciliary care agency providing personal care and support to people living in their own homes within the London Borough of Hillingdon. Most people had their care funded and organised by the local authority. At the time of the inspection there were approximately 144 people receiving support from the agency.

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 provider had a complaints procedure that was offered to all people. However, they did not always follow their own complaint procedure in that complainants did not always receive a full and comprehensive response after their complaints had been fully investigated. The provider’s quality assurance mechanisms had also not identified this shortfall, so this could be rectified.

People using the service and their relatives gave us mixed views about not being told if care workers were running late. Some people's experience was that the service did not communicate effectively with them, while other understood that the service offered a two-hour window around the appointment time.

Despite some concerns regarding lateness, people reported they felt safe with the care workers who supported them. There was a safeguarding policy and clear procedures in place. Care workers were aware of how to raise a safeguarding concern. They knew how to keep people safe and received training in safeguarding adults. Care workers were recruited safely and underwent all the necessary checks. medicines were also managed safety.

There was information available throughout people's support plans which enabled staff to provide person centred care. People and their representatives had been involved in the care planning process.

Risks to people's health and well-being were identified and managed by staff. Each person had a risk assessment and risk management plans that identified, managed and mitigated those risks found.

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.

Staff had developed caring relationships with people, which respected their dignity and privacy and promoted their independence. People's care and support met their needs and reflected their personal preferences. People were supported to eat their meals according to their preferences.

The provider worked in partnership with key organisations such as healthcare professionals to plan and deliver an effective service for the people who were receiving care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 27 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the handling of complaints. 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 for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.

Mears Care Limited is the domiciliary care division of Mears Group PLC. Mears Care – Hounslow is a location from where services are provided to people living in the London Boroughs of Hounslow and Ealing, who require care in their own homes. The service caters for people with a variety of needs including older people, people with a physical or learning disability, people with mental health needs and children. At the time of the inspection there were 146 people using the service with the provider offering approximately 1,700 hours of care each week. The majority of people had their care funded, or part funded, by the London Boroughs of Hounslow or Ealing.

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 and associated Regulations about how the service is run.

At the last inspection on 10 February 2015 we rated the service Good.

This inspection took place on 7 March 2017 and we found the service remained Good.

People using the service and their representatives were happy with the care they received. Their needs were being met and they had opportunities to be involved in planning and reviewing their care. They told us their choices were respected and the service was responsive to their needs, making changes to the times of visits or type of care if this was requested. People told us the care workers were kind, considerate and they had good relationships with them.

People were kept safe, because the provider had systems to help protect them. These included up to date risk assessments which outlined how the care workers should help to protect people when caring for them. The care workers usually arrived on time and stayed for the agreed length of time. People had the same regular care workers and felt they were in safe hands.

The staff received comprehensive inductions, training and support. They liked working for the provider and they felt they had the information and support they needed to care for people. They had been recruited in an appropriate way and the provider regularly checked how they were working by observing them in the work place, meeting with them to discuss their work and asking for feedback from the people who used the service.

The service was appropriately managed. The registered manager had systems for monitoring the quality of the service. This included asking for the opinions of people using the service, their representatives, staff and other stakeholders. Complaints were appropriately investigated and responded to. There was evidence the registered manager analysed complaints, incidents, accidents and feedback and improved the service as a result of this analysis.

The provider worked closely with the local authority and other agencies to promote good community support for vulnerable people. For example, they paid particular attention to the needs of people who did not have family or others looking after them. This included providing staff for emotional support and company, supporting social activities and providing hampers and time for people who were on their own during the Christmas period.

People told us they had been involved in decisions relating to their care and both office staff and care workers were polite, helpful and adequately trained to meet their needs. People said that care workers were usually on time and stayed the length of the visit, however, when their regular care workers were unavailable the standard of care did not always meet expectations.

People were protected from abuse, the provider had safeguarding procedures in place and staff had received appropriate training.

The agency had carried out the necessary checks to ensure care workers were of suitable character to work with people using the service.

Effective systems were in place in to monitor the quality of the service provision including satisfaction surveys, telephone calls to people using the service, spot checks of care workers and monitoring of punctuality. Where shortfalls were identified, actions had been taken to address them.

People said the care workers were familiar with their needs and cared for them well. Relatives who spoke with us confirmed this. One person said, 'we have a permanent care worker and we do not have any worries about them'. Another told us, 'they [the care workers] do what they should do and I am very happy'. People felt involved in their care and said their privacy and dignity was promoted by staff.

Care plans and risk assessments appropriately addressed people's needs and these were kept up to date to make sure people's needs were being met appropriately. People and their relatives were involved in this process. Although people were happy that all their needs, including their cultural and social care needs were being met, their care plans did not address these needs comprehensively. There were therefore risks that the same priorities were not given to these needs as to other care needs.

People were satisfied with the punctuality of their care workers but some of the records we looked at showed that not all visits took place according to the scheduled time. We saw that some visits were taking place outside the half an hour interval of the time of visits. This meant that people might not be getting the care they needed at the time they wanted.