Archived: Mears Care - Mitcham

Updated 31 March 2016

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.

This inspection took place on 23 February 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. The inspection was undertaken by three inspectors and an expert 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.

Prior to the inspection we reviewed the information we held about the service including the statutory notifications we received about key events that occurred at the service. The provider also completed 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 sent questionnaires to people, their relatives and health and social care professionals involved in the care provided to people to obtain their views about the service. We received completed questionnaires from 15 people, three people’s relatives and two health and social professionals, including representatives from the local authority.

During the inspection we visited the service’s office and spoke with eight staff, including the operations manager, care co-ordinators, visiting officers and the branch trainer. Visiting officers are staff that support people and care workers in the field. This includes reviewing people’s support plans and risk assessments, and checking the quality of support delivered by care workers. We reviewed ten staffing records, and 15 people’s care records. We looked at records relating to the management of the service, including complaints, safeguarding investigations, staff meeting minutes and findings from quality surveys and audits.

As part of the inspection we also undertook phone calls to 23 people, seven relatives and 15 care workers to obtain their views about the service.

Updated 31 March 2016

We undertook an announced inspection on 23 February 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. This was the first inspection of this service at this location.

Mears Care – Mitcham provides personal care and support to people living in their own homes. At the time of the inspection 176 people were using the service.

There was a registered manager in place. 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 registered manager was on leave at the time of our inspection. Staff were being supported by the care co-ordinators and the provider’s operations manager to ensure there was adequate management of the service.

Systems in place to review the quality of service provision were not robust and did not ensure consistent high quality care was provided. Communication between staff and with people required improvement. We heard that messages were not always passed on and requests for calls were not always returned. This was particularly in regards to the communication between the on call service and the local staff, and between the on call service and people receiving support. Meetings were being held between the office staff and the on call team to address the concerns regarding communication.

Processes were in place to obtain people’s feedback about the support provided. Systems were also in place to review and monitor the quality of care provided. Staff received ‘on site observations’ in which the visiting officer’s reviewed the quality of support provided by care workers and ensured this was in line with people’s care packages. Audits were undertaken on the quality of care records. We saw that improvements had been identified to ensure accurate records were maintained and this was in the process of being addressed with individual staff members.

Staff told us there was good colleague support and care workers felt well supported by the office staff. However, there were inconsistencies in the level of support staff received from the registered manager. Many of the staff felt they were not able to approach the registered manager if they required advice or wanted some additional support.

Staff received regular training to ensure they had the knowledge and skills to undertake their roles. However, there were inconsistencies in the level of support staff received. Staff did not always receive supervision in line with the provider’s processes, and many of the staff had not received an annual appraisal. The management team were aware of this and were in the process of scheduling supervision and appraisal meetings.

In the majority, people received care and support that met their needs. Staff worked with people to identify what level of support they required and how they wanted that to be delivered. People were involved in decisions about their care. Detailed care records were kept outlining people’s support needs, and people’s preferences in regards to how support was delivered. These records were updated regularly and in response to changes in people’s health. Staff provided people with support in line with their care records.

For the majority, people received support at the time they requested and staff stayed the required amount of time to care for people. However, we heard that at weekends this was more difficult and staff were at times late. In general, staff were allocated people to support and people had built caring relationships with the staff that visited them regularly. However, we heard that particularly at weekends that was a lack of consistency in the staff that supported them, and people were not always informed about changes in the staff visiting them.

Staff assessed the risks to people’s safety. Staff were knowledgeable about the potential risks to people’s safety, and supported them to minimise those risks. Staff liaised with other healthcare professionals if they had concerns about a person’s health or welfare.

People were provided with support in regards to their personal care, and also in regards to activities of daily living. Staff were aware of people who were at risk of malnutrition and dehydration. Staff helped people with meal preparation and ensured they had access to drinks throughout the day.

For people that required it, staff supported them with their medicines. People received their medicines as required. However, improvements were required in regards to the records kept about medicines administered. These improvements had been identified and were in the process of being addressed with individual staff members.

Staff were aware of their responsibilities to safeguard people and minimise the risk of harm. Staff adhered to reporting requirements in regards to incidents that occurred at the service, to ensure appropriate action could be taken to support the person and minimise the risk of incidents recurring. Staff supported people to make complaints and people were aware of the complaints procedures. Complaints were investigated and appropriate action was taken to address the concerns raised.

We identified a breach of legal requirements in relation to good governance. You can see what action we have asked the provider to take at the back of the main body of the report.