28 November 2017
During a routine inspection
The inspection took place on 28 November 2017. We gave the provider notice 48 hours before the inspection as the service provided personal care to people in their own homes and we wanted to be certain someone would be available to assist with the inspection.
At the last inspection on15 December 2015 we rated the service Good.
At this inspection on the 28 November 2017 we found the service remained Good.
Mears Care – London is a branch of Mears Care Limited, a national provider of care services. The Mears Care – London branch provides personal care and support to people living in the London boroughs of Camden, Lambeth, Tower Hamlets and Islington. The branch is known locally as Mears Care – London Central. At the time of our inspection they were providing a service to approximately 150 people, with the majority of these living within Camden and Lambeth. Most people were older adults, some living with the experience of dementia. A small number of younger adults with learning disabilities, mental health needs and physical disabilities used the service.
There was a registered manager in post. 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 and associated Regulations about how the service is run.
People using the service and their relatives told us they were happy with the care provided. They liked the care workers and told us they were kind, polite and considerate. People told us that care workers did not always arrive at the same regular times each day and they did not like this. The provider's own feedback from people using the service was that people wanted the same regular care workers and this did not always happen. The provider had already taken action to address these two areas of concern. They had introduced a new way of allocating the care workers so that there was more consistency with the care workers and the timings of visits.
People felt safe using the service. They were happy with the support they received when moving around their home and with medicines. The care workers were trained so that they understood about infection control, safe manual handling techniques and how to administer medicines. There were clear procedures in respect of these areas and the provider carried out regular checks to make sure care workers were following these. There were procedures regarding safeguarding adults and we saw evidence that the provider worked with the local safeguarding authority and other organisations to help protect people from the risk of abuse.
There were enough staff employed to care for people and meet their needs. The registered manager explained that they were recruiting new staff so that they could offer more specialised services, such as reablement support (short term care packages designed to support people to regain skills following a fall or hospital admission). New members of staff had an induction into the service, training and information to help them understand their roles and responsibilities. The provider organised regular assessments of the staff to make sure they were competent and had the skills they needed. The staff had opportunities to refresh their knowledge with annual training updates.
People's needs were assessed and planned for. They were consulted as part of these assessments and had consented to their care and treatment. Care plans were clear and had information about how to meet individual needs. People using the service were given a pack of information, which included their care plan and details about the service they could expect. The provider arranged for regular reassessment of people's needs to make sure care plans were current and reflected any changes. The provider worked closely with doctors, community nurses and other healthcare professionals to make sure people's care needs were being met. We saw evidence that they had alerted healthcare professionals to changes in people's needs and requested additional support when necessary.
There was a clear management structure within the branch and wider organisation. The staff were aware of this and felt communication within the organisation was good. Records were appropriately maintained and up to date. The provider had systems for monitoring the quality of the service, which included asking people using the service and other stakeholders for their views. We saw that the provider had listened to these and responded by making the changes which people had asked for. There were other improvements which the provider had introduced, for example, additional monitoring of people's condition and health. Their regular review and assessment of the services offered at this branch and others allowed the provider to identify where changes were needed. The provider had learnt from incidents and had made changes to prevent further occurrence of these.