About the service Multilink Management Care Ltd is a domiciliary care service providing personal care to people in their own homes. At the time of the inspection 17 people were supported with their personal care needs.
People’s experience of using this service and what we found
Some improvements had been made to the service since our last inspection in November 2020, however the provider’s action plan had not been effective in addressing the shortfalls in relation to safe care, recruitment and quality monitoring we found at our previous inspection. People may be at risk as the service continued not to meet all the regulatory requirements.
Systems to monitor the quality and safety of the service were ineffective and had not identified the concerns we found in relation to people’s risks and medicines management, assessment of staff knowledge and staff recruitment prior to our inspection. Whilst the registered manager delivered care and had some oversight of the service, they had failed to ensure people received a well-managed service which was safe.
Risk assessments were not robust enough and did not contain enough information of the actions to take to minimise risks to people and to direct staff in how people should be supported. Clear medicines management records were not in place for some people. Staff we spoke with told us they understood their roles and responsibilities and felt supported by the registered manager. However, staff had not always received up to date training to ensure they could always provide safe care. Systems to support staff in their induction and probation period had not been completed.
Robust recruitment systems were still not effectively used to ensure people were supported by staff of good character.
People and relatives, we spoke with said they felt safe when staff visited them and had no concerns about the care and support, they received. People were supported by staff who were familiar with their needs, however some people felt staff could be more punctual as they sometimes arrived late which impacted on their care and well-being.
Spot checks and observations of staff visits in people's homes were carried out but not always recorded. This meant that the provider could not be sure staff were supporting people as they wished and meeting their support needs.
People reported that staff has good infection control practices and wore the appropriate PPE.
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)
The last rating for this service was requires improvement (published 31 December 2019) and there were multiple breaches of regulation.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 15 and 20 November 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in safe care and treatment, fit and proper persons employed and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions ‘Is the service Safe and Well-led?’ which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Multilink Management Care Ltd on our website at www.cqc.org.uk.
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 and continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified repeated breaches in relation to safe care and treatment, fit and proper person’s employed and governance at this inspection.
Where we are taking or proposing to take enforcement action but cannot yet publish the actions due to representation and appeals process the text below must be added under this heading
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.