Archived: Mears Care Limited Leeds

Updated 27 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 was a comprehensive inspection. The inspection took place on 17, 18 and 25 July 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service providing support to people in their own homes. We needed to be sure that someone would be available at the office to assist us with our enquiries.

This inspection was carried out by one adult social care inspector and one expert by experience. The expert by experience had experience of caring for a person with dementia and completed telephone interviews on 18 July 2017.

Before this inspection we reviewed information we held about the service. This included reviewing statutory notifications that we had received from the provider. Statutory notifications are notifications of certain events and incidents that the provider has to inform the CQC by law. We used this information to help plan the inspection. We also contacted the local authority, local safeguarding team and Health watch to gather their feedback about the service.

During the inspection we spoke with 13 people who used the service, the manager, one co ordinator and six care workers. We looked at a range of records including 10 staff files relating to recruitment, supervision, appraisal and training. We also looked at 14 people's care records which included care planning documentation, risk assessments and daily records. We viewed records relating to the management of the service, surveys, audits and a wide variety of policies and procedures.

Updated 27 September 2017

This inspection took place on 17, 18 and 25 July 2017 and was announced. The provider was given 48 hours’ notice because the location provides domiciliary care services and we needed to be sure that someone would be in the office. We contacted people who used the service and staff by telephone on 18 July 2017 to ask for their views. On the 17 and 25 July we spent time at the office site, speaking to staff and reviewing relevant documentation.

Mears Care is a domiciliary care service that provides personal care to people in their own homes within the Leeds area. Mears Care was registered with CQC in July 2016 and this was the first inspection of the service. The service provides care for older people and people living with dementia, mental health, physical disabilities and sensory impairment, learning disabilities or autistic spectrum disorder, older people, people who misuse drugs and alcohol, people with an eating disorder and younger adults. At the time of our inspection there were 272 people using this service.

The service had a manager although they were not the registered manager. The manager told us they are in the process of applying to the CQC for registration purposes. We checked this and saw the manager had recently had an interview with the CQC as part of this process. 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.

We found medicines were administered but that administration was not always documented correctly. Staff signatures to confirm they had supported people to take their medicines and other information written on the Medicines Administration Record Sheets (MARs) were not always clearly written. Not all MARs charts were audited monthly and the audits we did see were completed several months after they had been completed.

Governance structures were in place but these were not being followed in accordance with the provider’s procedures and policies. For example, audits for medicines were not being followed up with actions taken and not all supervisions had been completed within the provider’s policy timeframe.

The manager was compliant in notifying the CQC of all medication errors and some incidents. Services that provide health and social care to people are required to inform the Care Quality Commission (CQC) of important events that happen in the service in the form of a 'notification'.

Some people using the service did not have capacity. We found people’s care records did not include information to reflect that assessments had taken place where people lacked capacity, and there was no evidence that best interest’s decisions had taken place, where relevant. No systems were in place to monitor if a person’s capacity had been reviewed.

Staffing levels were adequate to meet people’s needs and there was consistency with the same staff attending care calls whenever possible. Staff were recruited in line with the providers policy, inductions took place and staff received appropriate training.

Risk assessments were completed and reviewed to support people with specific needs to avoid any harm.

People told us they felt safe when being supported by staff. People using the service felt confident to raise any safeguarding alerts and staff had a clear understanding of the relevant policies and procedures.

Where people required assistance, they were supported to eat, drink and maintain a balanced diet. People were also supported with their health needs and this was evidenced in care records. Staff told us they also supported people to attend hospital appointments if needed.

People using the service and staff had positive relationships and people told us they felt well cared for. People were encouraged to be independent and make choices regarding their care. Staff respected people’s privacy and dignity when in their home.

Care plans were detailed and included relevant information such as initial assessments and instructions for staff to follow. People received personalised care which responded to their specific needs and preferences.

Complaints were responded to with letters and appropriate outcomes had been recorded. Incident and accidents were managed via an online system and people using the service told us they felt confident to discuss any concerns with the provider.

All of the people we spoke with said the manager was approachable, supportive and listened to others. People using the service were happy with the care provided and with management.

Staff meetings took place and staff were encouraged to discuss proposed improvements for the service. Surveys were provided to people using the service to monitor the quality of the care provided.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014; you can see what action we told the provider to take at the end of the full version of this report.