Archived: Mears Care - Kirklees

Updated 26 June 2015

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 is 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.

The inspection took place on 23 March 2015 and was announced. The provider was given 48 hours’ notice to ensure that people would be available in the office to talk to us, as the service is community-based.

The inspection team comprised of two adult social care inspectors who visited the branch office and two experts by experience who conducted telephone interviews with people who use the service and their relatives. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to our inspection we reviewed information from notifications, the local authority commissioners and local authority safeguarding team. This included detailed contract monitoring reports and outcomes of safeguarding investigations. We had received some information of concern regarding the reliability of the service provision due to missed visits and late call times. We had not sent the provider a ‘Provider Information Return’ (PIR) form prior to the inspection. This form enables the provider to submit in advance information about their service to inform the inspection.

We spoke with ten service users and fifteen relatives from a sample size of forty people. We also interviewed ten members of staff including four carers, two senior carers, two co-ordinators, a visiting officer and the registered manager. We took a cross sample from each geographical area to ensure a balanced perspective.

We looked at twenty care records, four medication administration sheets and sixteen personnel files. We also reviewed the complaints log, monthly audits of care records and medication sheets, and the findings from the most recent quality assurance survey.

Updated 26 June 2015

The inspection of Mears Care – Kirklees took place on 23 March 2015 and was announced. We told the provider that we would be coming because we needed to be certain there would be people in the service for us to talk to. We previously inspected the service on 1 September 2014. The service was not in breach of the Health and Social Care regulations at that time.

Mears Care – Kirklees is a domiciliary care agency registered to provide personal care to people in the community in the West Yorkshire area. The agency covers north Kirklees, south Leeds, Barnsley, Calderdale, and Wakefield. The main office is in Liversedge with a satellite office in Hemsworth. There are 181 people registered to use the service in Kirklees and Leeds, 192 in Wakefield and Barnsley and 107 in Calderdale.

There was a registered manager in post who had been registered since October 2010. 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.

The service is split into three main geographical areas for day to day management and there are currently two managers applying to be registered managers with the Care Quality Commission who will be responsible for Wakefield and Barnsley, and Calderdale areas respectively.

People told us they felt safe using the service and relatives were confident in the staff’s ability to care well. We saw that continuity of staff was preserved for people wherever possible, ensuring that positive relationships were built.

We were concerned that although the recruitment process seemed detailed there was a lack of consistency in checking references. Some were from relatives and friends which defied Mears’ own policy of not accepting references from these groups of people. Where concerns had been identified, these were not always followed up. This is a breach of Regulation 18 Health And Social Care Act 2008 (Regulated Activities) Regulations 2014 as the provider was not ensuring all appropriate checks were taking place for staff they were employing.

In addition, we saw that while we were confident staff had received the necessary training and were competent in administering medicines where this was specified, the records that were kept were not always correctly completed. This was also the case for the application of creams for someone where there was no detail as to which part of the body these should be applied and in what quantity. This is a breach of Regulation 12 (g) Health And Social Care Act 2008 (Regulated Activity) Regulations 2014 as medicines were not being properly and safely managed.

Staff received a thorough induction and we saw evidence of comprehensive notes and tests having been undertaken by new staff. Where training required regular updating, this was also completed. We saw evidence of supervision having taken place for some staff but not all. It was acknowledged by the registered manager that time constraints had reduced this for some people but there were plans in place to ensure all staff received their required sessions. In some areas this had been booked in.

We saw evidence in communication logs and records that staff were aware and asked people for their consent before undertaking any care tasks. This demonstrated that staff had a good awareness of the Mental Capacity Act 2005.

People told us they found staff very caring and were very complementary about how staff responded to individual needs. It was evidenced that staff were keen to promote people’s independence wherever possible while completing their required tasks.

The care records we looked at were detailed and person-centred. They showed the registered provider had a good understanding of looking at people as individuals and were keen to meet personal preferences wherever possible. All records we saw were signed, dated and timed providing a comprehensive record of tasks completed with someone.

There was also evidence that complaints were handled promptly and effectively as outcomes were mostly positive. Where more difficult decisions about staff performance were required, it was clear the necessary actions had been fulfilled.

People told us they were happy in communicating with the care staff who visited but were not always convinced messages were passed on. This was reflected in the haphazard nature of audits taking place and the shortfall in spot check visits.

You can see what action we told the provider to take at the back of the full version of the report.