Moonstone Care UK

Updated 7 January 2022

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

This inspection was carried out by two inspectors. An Expert by Experience made calls to people and relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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 and the provider 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 21 hours’ notice of the inspection. This was because we wanted to be sure the registered manager was available when we visited the office. Inspection activity started on 29 September 2021 and ended on 1 October 2021. We visited the office location on 29 September 2021.

What we did before inspection

We reviewed information we had received about the service since they registered with us. We sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. 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 inspected the service and made the judgements in this report.

During the inspection

We spoke with 13 people who used the service and seven relatives about their experience of the care provided. We spoke with 16 staff members, including the registered manager, a supervisor and 14 care workers. We reviewed a range of records, including three people’s care records and associated risk assessments. We looked at three staff files in relation to recruitment and staff supervision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, call logs, three care plans and associated risk assessments. We spoke with the local authority contracts team. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 January 2022

About the service

Moonstone Care UK Limited is a domiciliary care agency which provides personal care to people living in their own home. At the time of the inspection 35 people were using the service.

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

We found recruitment practices were not always safe. We could not be assured that staff employed were of good character and safe to work with people. Risk assessments lacked detail on how to mitigate the risks people faced and staff were not always sufficiently deployed. Therefore, we could not be assured that people’s need were always met in a safe way. Medicines were not always managed safely, which meant we could not be assured people received their medicines as prescribed. Care plans were not always consistent, and people did not receive personalised care. Systems for monitoring the service were not always effective in identifying the issues found during our inspection. Audits were not routinely carried out.

People were treated with kindness and compassion, however, we found people’s assessment of need required more detail to include, for example, their preferences for how they wanted to be cared for. We have made a recommendation in relation to the recording of assessments.

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 asked people for their consent before providing care.

People using the service, their relatives and staff were complimentary about the way the registered manager ran the service and how approachable they were. People and relatives told us they felt safe with care staff who treated them with dignity and respect. People were involved in decisions about their care and staff were described by people and relatives as caring and kind. Staff received training and supervision to assist them to effectively carryout their role.

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

Rating at last inspection and update

This service was registered with us on 21 January 2019 and this is the first inspection.

Why we inspected

This was a planned comprehensive inspection based on the service starting to deliver personal care to people in December 2019.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to staff recruitment, risk management, staffing levels, assessments and care planning and systems for monitoring and auditing the service.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.