28 May 2015
During a routine inspection
We inspected Mears Care on 28 May 2015. Mears Care (Oxford) is a domiciliary care agency providing care and support to people who live in the community. This was an unannounced inspection. This service was last inspected in August 2013 and it was meeting all the essential standards reviewed.
The service had a registered manager, however, they were not in day to day control of the service. A new manager had recently been recruited and was in the process of taking on the registration. 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.
Since the last inspection a number of managers had been in post and begun but not completed the process of their registration with CQC. This has meant senior staff from the provider had been in day to day control of the service. This has led to decisions not always being made at the appropriate level and support with these decisions from more senior management being described as “not always aware”.
People told us they felt safe. However, risks associated with people's support needs were not always documented with clear guidelines on how staff should mitigate those risks. Safeguarding incidents were not always raised in line with the service's safeguarding policy.
People told us staff were skilled and knowledgeable about their needs. New staff received a formal induction along with pre-assessments to capture their skills regarding tasks they would need to carry out such as numeracy skills. This was also supported by a formal period of shadowing. However, support to staff after induction was not regularly provided. Staff were not receiving regular supervision or appraisal. Staff did not have development plans in place.
The service were not adhering to the principles of the Mental Capacity Act 2005. The MCA provides a legal framework to assess people’s capacity to make certain decisions, at a certain time. We have made a recommendation the Registered manager ensures the services is familiar with the MCA Code of Conduct.
People were involved in their care planning and the service involved relatives as and when necessary. Assessments were undertaken of people's needs to create support plans, but these support plans were not always up to date or regularly reviewed.
Most people described staff as caring and supportive, but a few people we spoke with told us staff had not treated them in a caring and respectful way. Staff we spoke with expressed a caring approach and supported people well to maintain their independence.
There were systems in place to monitor the quality and safety of the service but they were not always effective in driving improvement of the service or used consistently.
We identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the CQC (Registration) Regulations 2009. You can read more about these in the full report.