Mackley Homecare Limited

Mackley Homecare Limited is a domiciliary care agency located within the Borough of Bromley. It provides personal care and support to people living within their own homes. Not everyone using Mackley Homecare Limited may receive a regulated activity. CQC only inspects the service being received by people provided with personal care; that is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection the service was providing support to 10 people.

People’s experience of using this service

People and their relatives spoke positively about staff and the care they received. Safeguarding and whistle blowing policies and procedures were in place and staff had a good understanding of them. Recruitment checks took place before staff started work and there were enough staff to meet people’s needs appropriately. Risks to people were assessed to ensure their needs were safely met. Medicines were managed and administered safely. Policies, procedures and personal protective equipment was in place to reduce the risk of infections.

Assessments of people’s needs and wishes were completed before they started using the service. People received support to access services where required. People were supported to maintain a healthy diet where this was part of their plan of care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's diverse needs were met appropriately. People's communication needs were assessed and met. People knew how to make a complaint if they were unhappy with the service.

There were systems in place to monitor the quality of care that people received. The service worked in partnership with health and social care professionals. The provider took people’s views into account and used their feedback to help drive service improvements.

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

Rating at last inspection

The last rating for this service was good (published 03 April 2019), however we made a recommendation to ensure the timely implementation of medicines policies and practices. At this inspection we found improvements had been made.

Why we inspected

This was a planned follow up inspection to assess if the provider was complying with our regulations.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

People’s experience of using this service:

¿ Some improvement was needed to ensure a recommendation we had made at the last inspection in relation to medicines management was fully acted on in a timely way.

¿ The registered manager assessed and monitored the quality of service delivered through spot checks, monitoring visits and audits. However, the medicines audit required some improvement to ensure they were fully effective.

¿ The registered managers worked together and communicated regularly. They understood their roles and responsibilities and their registration requirements.

¿ People and their relatives’ views about the service were sought and considered to make improvements.

¿ The registered managers worked in partnership with the local authority and health and social care professionals to meet people’s needs

¿ People felt safe using the service and staff had a clear understanding of safeguarding procedures.

¿ There were enough staff to meet the needs of people using the service. No new staff had been recruited but there was a system for safe recruitment practices to be followed.

¿ Risks to people had been identified and assessed to ensure people’s needs were safely met.

¿ People were receiving their medicines as prescribed by health care professionals and staff understood how to reduce the risk of the spread of infections.

¿ Assessments of people’s care and support needs were carried out when they started to use the service.

¿ Staff received training and support to meet people’s needs.

¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

¿ People were supported, where needed to maintain a balanced diet.

¿ People told us staff were kind, caring and respected their dignity and privacy. They enjoyed having the same staff members to give them care and support.

¿ People were consulted about their care and support needs.

¿ People received personalised care from staff members who knew them well.

¿ Staff received training on end of life care and end of life care and support could be provided to people when required.

¿ People and their relatives knew how to make a complaint if they were unhappy with the service.

Rating at last inspection: Good (Report published on 13 December 2016).

Why we inspected: This was a planned inspection based on the last inspection rating.

Follow up: We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received we may inspect sooner.

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

Mackley Home Care Limited is a domiciliary care service providing personal care and support for people living in their own homes in the Bromley area. At the time of this inspection there were approximately 25 people using 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 2008 and associated Regulations about how the service is run. At the time of this inspection the operations manager was in the process of applying to job share with the current registered manager.

People received their medicines when they should and staff had received training on the safe administration of medicines. However we found some aspects of the medicines policies and procedures required updating to include current guidance for staff. We have therefore made a recommendation about some aspects of the safe management of medicines. We will check the progress on this at our next inspection.

People told us they felt safe from harm and well cared for by the service. Care workers had received training on safeguarding adults, so they knew the signs of possible abuse. There were suitable arrangements to deal with a range of emergencies if needed. Possible risks to people were identified and guidance was in place to reduce risk.

People said their care workers were caring and kind, and, that some of them went out of their way to support them. People had the same care worker or small group of care workers, who they said knew their needs and preferences well. People said they were involved in decisions about their care and they were treated with respect and dignity at all times.

People commented that their care workers were reliable and were rarely late. There were enough care workers and office staff to meet people’s needs and the provider followed safe recruitment policies. Staff received suitable training and support to carry out their roles. People were asked for their consent before care was provided and staff were aware of their responsibilities under the Mental Capacity Act (2005). People’s dietary needs were met, where they needed support to manage this. The service worked with health professionals, when necessary, to ensure people’s changing health needs were addressed.

People had an assessed and written plan of care available in their homes; these were up to date and people told us they reflected their needs and individuality. People said they were involved in reviewing the plans and that any changes were updated in the care plan. There was a complaints procedure and people knew how to raise a complaint.

People and their relatives told us the service was efficient and provided consistently good care. It was a small service with a stable management team, who, were involved in direct care delivery and therefore had frequent contact with people. They were therefore familiar with people’s needs and able to directly monitor the quality of the service. There were robust communication systems about people’s needs and staff felt well supported in their roles. People told us they were asked for their views about the service and felt listened to and that the service considered any improvements that could be made.

We found that the care was planned and delivered in a way that met people's needs. Risk assessments and care plans were individualised and reflected people's needs. The provider sought people's consent and agreement before a care package was started. Staff were aware of safeguarding procedures and knew how to raise concerns. Staff received medication training via an eLearning programme in order to support people to take their medication. Records were adequately maintained and following our visit are now stored securely.

We found that care plans had been re written and reviewed on a regular basis and information was clearly documented. Staff were not supported to deliver care and treatment safely and to an appropriate standard because mandatory training had not been completed at the frequency stipulated within the providers policies.