Background to this inspection
Updated
9 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 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.
This inspection took place on 19 June 2017 and was announced. The provider was given 48 hours’ notice because the service is a home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.
The inspection team consisted of an inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they intend to make.
Before our site visit we spoke with six people who used the service and relatives of nine other people. We looked at three people’s care plans and associated records. We looked at information about the support that staff received through training and appraisal. We looked at three staff recruitment files to see how the provider operated their recruitment procedures. We looked at records associated with the provider’s monitoring of the quality of the service.
We spoke with the registered manager, three managers who were mainly office based and three care workers.
We contacted the local authority that funded some of the care of people using the service and Healthwatch Northamptonshire, the local consumer champion for people using adult social care services, to see if they had feedback about the service.
Updated
9 September 2017
Mega Resources Nursing and Care Services is a home care agency supporting people who live in their own homes. At the time of our inspection 66 people used the service.
When we last inspected the service in April 2015 the service was rated ‘Good’.
The inspection took place on 19 June 2017 and was announced. We gave the provider 48 hours’ notice because the service is a home care agency and the registered manager is often out of the office supporting staff or visiting people who use the service. We needed to be sure they would be in.
The service had 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.
The provider had policies and procedures for keeping people safe. Staff received safeguarding training they put into practice and staff were periodically observed to monitor their practice. The provider had a recruitment procedure that ensured as far as possible that only staff suited to support people who used the service were employed. Prior to our inspection an incident had occurred. The registered manager took all appropriate steps and made the appropriate referrals to different agencies as soon as they became aware of the incident. We have made a recommendation about this.
People’s care plans included risk assessments of activities associated with their personal care routines. The risk assessments provided information for care workers that enabled them to support people safely but without restricting people’s independence.
Enough suitably skilled and knowledgeable staff were deployed to meet the needs of the people who used the service. Staff arranging home care visits were knowledgeable about people’s needs and arranged for staff with the right skills and knowledge to visit people.
People were supported to take their medicines at the right times.
People were cared for and supported by care workers who had the appropriate training and support to understand their needs. People we interviewed spoke about staff in complimentary and positive terms, though one family were displeased with the support their relative experienced.
Staff were supported through supervision, appraisal and training. They received training to help them understand about medical conditions people lived with. Staff valued the support that they received because it helped them carry out their roles.
The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. People were presumed to have mental capacity to make decisions about their care and support unless there was evidence to the contrary. The registered manager attended to this after we brought it to their attention. Staff had awareness of the MCA. They understood they could provide care and support only if a person consented to it.
Care workers either prepared meals for people or supported people to make their meals.
They supported people to attend healthcare appointments and to access health services when they needed them.
Care workers were caring and knowledgeable about people’s needs. People were consistently supported by the same care workers. When staff rotas were prepared care workers were `matched’ care workers with people who used the service which supported them to build caring relationships.
People who used the service were involved in decisions about their care and support. They received the information they needed about the service and about their care and support. People told us they were always treated with dignity and respect, though that had evidently not been the case with one care worker.
People contributed to the assessment of their needs and to reviews of their care plans. People’s care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to.
The provider had arrangements for monitoring the quality of the service. There were arrangements for monitoring punctuality and duration of home care visits which were being improved. The provider had begun a review of how they monitored whether people were safe.
Further information is in the detailed findings below.