Archived: Cera - Leeds

Mears Care Limited Leeds is a domiciliary service providing personal care to 100 people aged 65 and over at the time of the inspection.

People’s experience of using the service

We found the provider did not always maintain appropriate or accurate records relating to supervisions, medicines and audits. Supervisions had not always been recorded, and medicine audits did not always identify the recording issues we found.

People felt safe with staff entering their homes and carrying out care. Staff protected people from harm and systems were in place to reduce the risk of abuse and to assess and monitor potential risks to people.

People received their medicines. However, records of medicine administration charts were not always accurate. Risk assessments had been completed and were reviewed. Incidents and accidents were managed effectively; lessons were learned to prevent future risks.

There were enough skilled and experienced staff to meet the needs of people who used the service. Staff completed training, supervisions and appraisals. Supervision records were not always carried out.

People said staff were kind and caring. Staff treated them with respect and dignity. People were involved in decisions about their care. People's right to privacy was maintained by staff.

People were involved in meal choices and supported to maintain a balanced diet. Health needs were regularly monitored, and staff involved healthcare professionals when required.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive was possible. Staff understood people’s likes, dislikes and preferences and people were offered choices about their care.

A complaints system was in place and complaints were managed effectively. People told us they knew how to complain if needed.

Surveys and telephone quality checks were carried out with people to gather their views. Meetings took with staff to communicate changes within the service.

Staff provided mixed reviews about the communicate within the service between the carers and office staff. Some people felt communication could be improved in relation to changes with their visits.

We found one breach of regulation 17.

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 6 November2018).

Why we inspected

This was a planned inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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 September 2017 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 183 people using this service.

The service did not have a registered manager due to the previous manager still being registered. CQC were aware of this prior to the inspection and were in the process of cancelling this so the new manager could apply. The manager had previously been a registered manager. 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 a lack of accurate and contemptuous records. Supervisions had not always been recorded, some people had not signed their care plans and audits of these were not consistent. We also found actions taken had not always been recorded when people had raised issues with the provider in quality telephone checks.

Risk assessments had been carried out and staff understood how to support people. However, these lacked details of how to support people and we found one risk assessment had not been completed when restrictive practice was being used.

People using the service told us they felt safe and staff had a clear understanding of how to safeguard people from potential harm or abuse. There was a safeguarding and whistleblowing policy available for staff and they told us they felt confident to raise concerns.

Medicines were managed safely. Some people were prescribed ‘as required’ medicines and we found protocols outlined when these would need to be administered, with body maps to show where creams needed to be applied.

Staffing levels were adequate to ensure visits were carried out. Some visits had been missed due to staff leaving their employment but most people told us they received their regular visits. Staff recruitment was robust and the necessary checks were carried out by the provider to ensure staff were safe to work with people using the service.

The provider operated under the principles of the Mental Capacity Act (2005), with capacity assessments and best interest meetings carried out.

New staff completed an induction program and training before carrying out personal care. Staff told us they did continuous training to ensure their skills were kept up to date and were supported with supervisions and appraisals. However, we did find that not all of these had been recorded.

People were supported with their nutritional and health needs. The provider ensured staff were trained to support people with specialist needs for example, catheter care.

People told us staff were caring and compassionate. Staff had built fond relationships with people they cared for and visits were consistent to ensure familiarity for people using the service.

Initial assessments were completed and care plans were then carried out. Care plans were individualised and detailed people’s preferences.

People said they were offered choices and encouraged to be as independent as possible. Staff were respectful of people’s diverse needs and for privacy. People said they were involved in their care planning and had copies of their care files within their homes. However, we did find some care plans had not been signed by people. Care plans also instructed staff to provide explanations when delivering care. This meant people were able to provide verbal consent.

Complaints were managed effectively with appropriate investigations carried out and lessons learnt to prevent re occurrences.

Some people and staff told us they did not know who the manager of the service was. The manager been in post for three weeks and was working to build relationships. The manager was honest and open about the improvements required to ensure the service provided quality care and had made plans to make sure people and staff knew who they were.

Surveys were sent out to gather people’s views and actions had been taken to improve the service. Newsletters had also been re-introduced to people and staff to enable better communication.