Archived: Meridian Health and Social Care - Lincoln

Updated 31 July 2021

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 an assistant inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes. at the time of this inspection the service did not have a manager registered with the Care Quality Commission. The provider is in the process of submitting a registered manager application. This means the provider is 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 because we needed to be sure that the provider would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

During the inspection

We spoke with ten people who used the service and one relative about their experience of the care provided. We spoke with ten members of staff including the provider, care director, area manager, branch manager, and care workers. We reviewed a range of documents including 16 people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Updated 31 July 2021

About the service

Meridian Health and Social Care – Lincoln provides care for people in their own homes. The service can provide care for adults of all ages. It can assist people who live with dementia or who have mental health needs. It can also support people who have a learning disability, special sensory needs and or a physical disability.

At the time of our inspection the service was providing care for approximately 141 people most of whom were older people. 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 quality assurance policy in place. However, the policy did not describe a clear scheme of delegation for undertaking audits to ensure regulatory compliance. There was insufficient detail regarding monitoring timeframes and who was responsible for the quality assurance process.

There was a lack of quality assurance processes in place to monitor the quality of the service and address shortfalls. For example, the provider did not audit planned hours against actual hours delivered.

People did not always receive their visits at the times they expected, people did not always receive their hours of care in line with their care plan and planned hours of care. Staff were not deployed effectively in order to meet people’s needs.

Medicine records had a lack of guidance and information for staff to safely administer prescribed medication. Medicine records were not consistently completed to show that people had received their medicines.

Communication with the office was not always effective. People told us when they raised issues, there was no evidence of action taken to resolve issues.

The care plans we reviewed contained conflicting information relating to people’s needs and were not always in line with other documentation.

People did not always receive care and support in line with their preferences. There was a lack of information and guidance for staff to understand conditions associated with people’s health.

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 requires improvement (published 14 March 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and quality assurance. A decision was made for us to inspect and examine those risks.

We received concerns in relation to the deployment of staff. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We have found evidence that the provider needs to make improvements.

Please see the Safe and Well-Led sections of this full report.

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

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to Regulation 12 Safe Care and Treatment, Regulation 18 Staffing, Regulation 17 Good Governance and Regulation 9 Person Centred Care at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.