Mcare24 Limited

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People told us they felt safe when supported by care staff and were happy with and complimentary about their care. Staff were aware of the risks to people, but care records were not up to date and did not always reflect people’s current needs. People were supported by safely recruited staff who knew them well.

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.

Right Care:

People were supported by staff who were aware of their responsibilities to protect them from harm. However, there had been a number of incidents where the provider had failed to recognise people were at potential risk of harm. The provider worked alongside other agencies in order to support people to meet their health care needs. People were supported by a consistent group of staff who knew them well.

Right Culture: We found some areas of the service that required improvement that the provider’s own systems and processes had not identified. These were in relation to ensuring information held in people’s care records was up to date and correctly risk assessed. People told us they had no issues getting hold of management and relatives were kept informed of events that affected their loved ones.

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 4 December 2017).

Why we inspected

We inspected this service due to the length of time since the previous inspection. This inspection was also prompted by a review of the information we held about this service. We completed a focussed inspection of the key questions safe, effective and well led. For those key questions not inspected, we used the rating awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for MCare 24 Limited on our website www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to good governance.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

A registered manager who was also the provider was in post at the time of our inspection. 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 was run.

People felt safe with all of the staff who provided care and supported them in their homes. There were arrangements in place to make sure there were sufficient staff available to meet people’s care calls and who understood the need to protect people from the risk of harm and abuse The registered manager had taken measures to reduce risks to people’s safety. Staff were trained in how to recognise abuse and understood the action they should take if they had any concerns people were at risk of harm. The registered manager checked staff’s suitability to deliver personal care in people’s own homes during the recruitment process.

People’s care plans included risk assessments for their health and wellbeing and explained the actions staff should take to reduce the identified risks. Staff understood people’s needs and abilities by working alongside experienced staff when they started working at the service, speaking with people about their needs and reading care plans.

The registered manager had developed a system to record accidents and incidents and to reduce any reoccurrence. Where people needed support to take their medicines they were assisted by staff who had been trained to do so. The registered manager had procedures in place to check people received their medicines as prescribed, in accordance with their health needs.

Staff received training and support to meet people’s needs effectively. Staff had opportunities to reflect on and improve their practice for the benefit of providing people with care and support to effectively meet their care needs. Staff recognised how their training had provided the knowledge of how to reduce the risks of infections spreading and had been provided with the right equipment to assist them in their daily care work.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. This included involving people in decisions about their day to day care. Staff knew which people may need help to make some key decisions about their lives and understood what action to take so people received the support they needed in these circumstances

Where people required support from staff with their meals and drinks this was provided. People were happy with how they could rely on staff if they needed assistance in accessing health care services when they needed them to get the best outcomes for people’s health and well-being.

People's care records were personalised and contained information about people's preferred daily routines. People who used the service and relatives were involved in the planning and review of their care so any changes could be responded to. The registered manager regularly delivered care and support, so they maintained an on-going relationship with each person.

People told us the staff who provided care and supported them in their homes were kind and respected their privacy, dignity and independence and said staff felt like their friends. People knew any concerns would be listened to and action taken to resolve any issues.

People were encouraged to share their opinions about the quality of the services provided during visits by the registered manager and at regular reviews of their care plans and through formal surveys.

The registered manager and staff team shared common values about the aims and objectives of the services they provided to people in their homes. People were supported and encouraged to live as independently as possible, according to their needs and abilities.

The registered manager had a candid approach to using the learning from external professionals and resources on the computer to aid the development of providing people with a home care service. The registered manager’s quality checking arrangements were continuing to be developed and included regular checks of people’s care plans and staff’s practice. When issues were identified action was taken to continually improve, develop and sustain the quality of the services provided to people in their homes.