Mark Time Care Limited

Updated 15 November 2019

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 team consisted of one inspector.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they are 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. Inspection activity started and finished on 22 October 2019, this is when we contacted people who used the service for their experience and spoke with some staff. We visited the office location on 23 October 2019 and met with the management team.

What we did before the inspection

We reviewed any notifications we had received from the service (events which happened in the service that the provider is required to tell us about). We also sought information from external agencies such as the local authority. We also asked Healthwatch Nottingham for any information they had about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with two people who used the service and seven relatives about their experience of the care provided. We spoke with the registered manager, senior care worker and three care workers. We reviewed a range of records. This included three people's care records. We looked at three staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including staff training, audits and checks.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and policies.

Updated 15 November 2019

About the service

Mark Time Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes within and around Nottingham. It provides a service to older and younger adults living with a range of health conditions and needs, to live independently in the community. Not everyone using Mark Time Care Limited receives regulated activity; 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. At the time of our inspection, 19 people were receiving personal care as part of their care package.

People's experience of using this service and what we found

Overall people told us they were happy with the care they received. In the main, people received care from regular staff who they had developed a positive relationship with.

Guidance for staff about how to meet people’s care needs and known risks, were inconsistent in the level of detail provided. Not all risks had been sufficiently assessed and planned for.

Where people required support with their prescribed medicines, staff were not following national best practice guidance. Improvements were required in the transcribing of medicines to ensure mistakes were not made.

We have made a recommendation about reviewing current medicine management best practice guidance.

Staff had received an induction and shadowed experienced staff. Staff had received training, but some training gaps were identified. Staff felt well supported by the registered manager, but opportunities for staff to discuss their work, training and development needs was informal.

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.

Staff ensured people’s hydration and nutritional needs were met and they liaised with external health care professionals, to support people with their health conditions. People were protected from the risk of cross contamination because staff followed infection control prevention and control practice.

Staffing levels were sufficient to meet people’s care needs and checks were completed on staff’s suitability to work with people. Staff had received safeguarding training and people knew how to raise any concerns or complaints. Where incidents had occurred, these were recorded, reviewed and monitored. Action was taken to reduce further risks.

Staff were kind, caring and compassionate and understood people’s needs. Staff encouraged people’s independence and upheld their rights. People were involved in discussions and decisions about their care, but this needed to be formalised.

End of life care was not being provided at the time of the inspection, but people’s wishes to some aspects of their end of life had been discussed with them.

Systems used to monitor the quality and safety of the service had recently been improved upon. This included oversight of people’s care package to ensure staff had completed visits in accordance to their assessed needs. People received opportunities to share their experience of the service they received.

The registered manager was found to be caring, responsive and showed a determination and commitment to drive forward improvements. Where shortfalls in standards were identified during this inspection, they took immediate action to make improvements.

The registered manager understood their registration regulatory responsibilities.

Rating at last inspection

This was the first time the location had been inspected therefore there was no previous rating. This service was registered with us on 3 October 2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on the registration date.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Follow up

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