Archived: Mayfair Homecare

Mayfair Homecare provides care for people who live in their own homes. Services are provided to older people, people with mental health issues, physical and learning disabilities and sensory impairment.

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

Assessments were not always undertaken to identify risks to people to protect them from harm. The management of medicines required improvement particularly around recording. However, people did say they received their medicines when needed. Accidents and incidents were not always recorded appropriately or analysed.

Training and supervision was not always effective or robust. People’s capacity to make decisions was not always being assessed where needed. Care plans required more detailed guidance and staff needed to ensure that information in care plans was read by them before they delivered care.

Quality assurance was not always effective. Where shortfalls had been identified with staff this had not been addressed robustly. Staff were not given travel time between calls which meant they were not always staying for the full length of the care call. However, people, relatives and staff were complimentary of the management team.

People told us that they felt safe with staff and that staff followed good infection control. Staff underwent a robust recruitment process before they started work. People were supported with health care appointments and staff ensured they had sufficient food and drink before they left the call.

People and relatives said that staff were kind and caring. We saw attentive interactions between staff and people. Staff ensured that people were listened to and were patient and respectful towards them.

Rating at last inspection

At the last inspection the service was rated Good (the report was published on the 12 November 2016).

Why we inspected

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

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 we receive any concerning information we may inspect sooner

The inspection took place on the 6 October 2016 and was announced. Prior to this inspection we had received concerns in relation to the care people were receiving during the transition of providers. We therefore needed to ensure that people's care was being delivered in line with the fundamental standards.

The service had a registered manager. Although they were no longer employed by Sevacare and had left the organisation in June 2016. 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. The provider had recruited a new manager who had been in post three days before our inspection.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse .The staff we spoke with were able to demonstrate what they would do should they have any concern that abuse was taking place.

Some people had risk management plans in place. The people we spoke with were aware of the need for risk assessing and were happy with what was in place to support them. However the provider was in the process of review all risk assessments since they had taken over the company. The operations manager told us that an action plan had been put in place to prioritise people’s assessments.

Staffing levels were adequate to meet people's current needs. However people told us some staff do not always stay for the full length of the call, this was in relation to calls where housekeeping tasks were involved. The provider has taken some action regarding this.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles.

People were supported to receive their medicines when they needed them. We were told by the majority of people we spoke to they did not have any issues with medicines and the appropriate gloves and aprons were always worn by the care workers.

Staff were well supported by the manager and senior team, and had regular one to one supervisions, and spot checks. The staff we spoke with were confident that the support they received enabled them to do their jobs effectively.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. Everyone we spoke with told us that staff members always gained their consent before carrying out any care tasks.

People were able to choose the food and drink they wanted and staff supported them with this. If required, staff supported people to access health appointments. We saw that people had information about their likes and dislikes with food and drinks, and dietary requirements recorded within their files.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. People were involved in their own care planning and were able to contribute to the way in which they were supported.

The service had a complaints procedure in place, where people had made complaints evidence was found that these complaints were recorded and acted upon appropriately.

Feedback was sought by the operational management via surveys which were sent to people and their relatives. Survey results were positive and any issues identified acted upon.

Quality monitoring systems were in place and when audits were being conducted there was evidence that actions were taken to address issues drive future improvement.

People that we spoke with told us that staff were kind, helpful and for the majority of the time they were punctual. One person told us. 'If my carer is running late the agency call to let me know but they have never missed a visit.' Another told us 'If the carer hadn't arrived after 15 minutes I'd call the office.'

Care plans and risk assessments were in place and the registered manager, or a named person from the office, carried out the assessments. Staff confirmed they looked at each person's folder in order to carry out the correct care for people.

Staff confirmed they received regular training sessions. This took place through e-learning, practical sessions in the office or face to face training. Staff confirmed they benefited from regular supervision sessions with their manager and an appraisal.

Staff that we spoke with confirmed with us that they had an induction when they joined the agency. They told us the agency supported them with training and ensured that this was provided for them.

Quality assessments were taking place. The agency audited medication charts, infection control procedures and distributed an annual survey to people who used the service.

We looked at 12 care plans to ensure that risk assessments were now in place for people. The registered manager had allocated this job to the responsible person in the agency and most of the risk assessments had now transferred on to the new documentation the agency had introduced.

We spoke to five people regarding their medication administration and we were told that medicines were given to them safely and the medication procedures for them worked well. We looked at medication administration records for people who used the service. The warning letter in December related to poor practice regarding warfarin administration. We found the agency have now addressed this issue. However we found further shortfalls in their medication practices. Staff responsible for ordering medicines for people had not done so and there were gaps on the MAR (medication administration record) for some people.

People confirmed they felt safe and all knew the process for making a complaint if they needed to. The manager explained that all people benefit from an assessment of their needs prior to care being delivered and we saw examples of those assessments.

Staff confirmed that they had access to training via e learning. They also told us the agency were supportive and if they had a problem they would telephone the manager.

We did find some shortfalls and have asked the agency to take action to address them. There were no risk assessments available for staff to enable them to safely care for people who used the service. There were some medication shortfalls and the agency did not have a robust quality audit system.