Background to this inspection
Updated
2 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and telephone interviews were undertaken by 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was due to the nature of the service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 6 June 2019 and ended on 7 June 2019. We visited the office location on both 6 and 7 June 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed the previous inspection report, notifications received from the provider, the action plan and information from the local authority.
During the inspection
We spoke with 25 people who used the service and six relatives about their experience of the care provided. During the inspection we spoke with the registered manager, deputy manager, a visiting officer and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We contacted 32 care workers via email for feedback on the service and we received responses from nine care workers.
We reviewed the care plans for eight people and the medicines records for five people. We looked at the recruitment records for four care workers and the training for all staff. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
2 August 2019
About the service
Mears Care – Richmond is a domiciliary care agency providing personal care and support to people living in their own homes within the London Borough of Richmond upon Thames. The majority of people had their care funded and organised by the local authority. They also provided short term care and support alongside the treatment provided by the health authority to people moving back home after an accident, hospital admission or operation. This type of support is known as reablement and is designed to help people to regain skills and confidence so that they can return to the lifestyle they had previously. The number of people who used the service changed regularly because the agency was one of the main providers used by the local authority. At the time of the inspection there were approximately 250 people were receiving support.
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
People using the service were supported to access the community to reduce the risk of social isolation. The registered manager had developed a system to carry out regular checks on people using to service to identify if they were at risk of social isolation and support them to access community services and groups.
Care workers administered people’s medicines in a safe way and as prescribed. The provider had processes in place for the recording and investigation of incidents and accidents.
People told us they felt safe when receiving care. Risk management plans were in place providing guidance for care workers on how to minimise risks for people using the service.
The provider had a robust recruitment process in place and there were enough care workers deployed to provide support. Care workers received the training and supervision they required to provide them with the knowledge and skills to provide care in a safe and effective way.
Detailed assessments of a person’s needs were completed before they started to receive visits. The care plans described the care and support a person required and how they wanted it to be provided.
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.
People were supported to eat a healthy diet and to access healthcare professionals when required.
The provider had a complaints process in place and relatives told us they knew what to do if they wished to raise any concerns.
There was a range of quality assurance processes in place to identify if any actions were required to improve the service. People using the service and staff felt the service was well-led.
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 1 November 2018). 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 inspection was carried out to follow up on action we told the provider to take at the last inspection.
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.