Background to this inspection
Updated
11 September 2018
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.
We gave the service four days’ notice of the inspection visit because the location provides a domiciliary care service, supporting people in their own homes. We needed to be sure that the registered manager would be available. Inspection site visit activity took place on 16 and 19 July 2018. We visited the office location to see the manager and office staff. We also reviewed care records and policies and procedures. We made telephone calls to people and their relatives on 17 July to seek their views on the service. The inspection team consisted of one inspector.
Prior to the inspection, we reviewed information we had about the service. We sought feedback from the local authority and three professionals. Initially, only the local authority responded. On inspection we met a nurse, who provided feedback.
The provider did not meet the minimum requirement of completing the PIR at least once annually. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we made the judgements in this report. Arrangements were made with the provider to submit their PIR following the inspection site visit. This information has been considered in the report.
During the inspection, we spoke with four members of staff and the registered manager. We contacted seven people and/or their relatives by telephone and visited three people in their homes. One professional involved with a person receiving support from the service spoke with us. A range of records were reviewed during the inspection including the care files for four people, which contained their care plans, daily records and medication records. We looked at three staff files which included their recruitment, induction, supervision and training records. We viewed a variety of information about the service such as policies and procedures.
Updated
11 September 2018
Mayflower Gateway Business Centre is a domiciliary care agency and supported living service covering coastal areas in North Yorkshire and Redcar and Cleveland including Brotton, Goathland and Robin Hoods Bay. Domiciliary care agencies provide personal care to people living in their own houses and flats in the community and specialist housing. The service was not providing any supported living at the time of inspection.
Mayflower Gateway Business Centre provides support for people with a range of needs including those living with dementia, people with learning disabilities or autistic spectrum disorder, mental health and older people. Where the care service supports those with learning disabilities or autism it has been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary life as any other citizen.
The amount of time for care visits ranged from 15 minutes to 12 hours. When we inspected, 44 people were receiving care. Not everyone who used the service received a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The inspection took place on 16 and 19 July 2018 and was announced on both days. The provider was given notice because the location provides domiciliary care services and we needed to be sure someone would be available to assist with providing information for the inspection. We contacted people who used the service and their relatives on 17 July 2018 to ascertain their views.
The service registered with CQC on 1 August 2017. This was its first inspection.
The service had a registered manager in place, who was also the nominated individual and registered provider. They were present throughout the inspection. A registered manager is a person who has registered with CQC 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 had not submitted a Provider Information Return (PIR) to detail what the service was doing well and any improvements they planned to make. This was completed following the inspection site visits. Not sending the PIR when this was requested limits the rating for well-led.
A log of significant events that happened in the service to ensure these were addressed consistently and to review any changes needed as a result had not been kept. The registered manager agreed to keep a record with these details. Audits were not being completed to identify and analyse trends across the service and show how improvements were made. We have made a recommendation about quality assurance.
Staff worked with families, involving them in people’s medication arrangements. Information was shared amongst staff, the person’s GP and family to ensure all parties had up to date details and were supporting people safely and effectively. The registered manager undertook to introduce protocols for ‘when required medicines’.
An electronic alert system informed the registered manager and deputy manager when key information had not been recorded following care visits for hydration, medicines or security. Alerts were checked to enable any action to be taken. This helped keep people safe.
The registered manager provided us with a health questionnaire on the second day of inspection and had made arrangements for staff to complete these.
Consent was understood by staff. We saw consent forms completed for people that had capacity to agree to their care arrangements. Where documentation had not been completed for one person who lacked capacity the registered manager agreed to action this.
There were sufficient staff to meet people’s needs and people received care at their preferred times. Changes were made to people’s care visit times to fit with their appointments and family arrangements. People’s care took into account their communication needs and how they wanted to be treated with dignity and respect. Care plans contained detailed information about people’s care needs and how to support them. Step-by-step instructions helped ensure a consistent approach to more complex care interventions. Staff were sensitive and respectful towards people and their properties. End of life care was recognised as requiring a unique, respectful approach.
Staff received training to equip them for their role. Some staff had ‘champion roles’ where they had completed additional training or experience in specific aspects of care.
The service was trusted and valued by people and their relatives. We received consistently positive feedback. There was mutual respect between staff and the registered manager. This helped ensure a motivated, high performing workforce.