We carried out a review of the data available to us about Marches Home Care Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Marches Home Care Services, you can give feedback on this service.
Marches Home Care Services Limited is a domiciliary care agency which provides personal care to people living in their own homes. At the time of our visit 28 people were being supported with personal care in their own home.
People’s experience of using this service:
We were repeatedly told by people and relatives that Marches Home Care Service Limited was very well-led. We found evidence during the inspection process which confirmed this was the case. The registered provider was committed to developing a service which was person-centred and responsive to people’s needs. There were strong links with the community to improve the health and well-being of people in general.
Everyone we spoke with said they would recommend the service to other people. They told us staff often went above and beyond to ensure people were happy and safe.
There was an emphasis on ensuring people were supported by an experienced and qualified staff team who knew people well. Training was individualised and developed around people’s needs. Additionally, the in-house trainer understood the importance of adapting training to meet individual staff learning styles. People said they were assured staff were experienced and appropriately trained.
People and relatives said individuals who used Marches Home Care Services Limited experienced positive outcomes. We reviewed compliments received by the service and saw people and family members had repeatedly praised the service for the improvements made to people’s lives.
People and relatives who used the service told us they were more than happy with the service provided. Staff were described as reliable, kind and caring.
People told us they felt safe when being supported by staff. Staff were aware of their responsibilities in reporting and responding to abuse and said they would not hesitate in reporting any unsafe or abusive practice. Staff told us the registered manager understood the importance of creating a culture where people were free from abuse and harassment.
When asked, everyone said they were happy with the processes for managing their medicines. Medicines were managed in line with good practice guidance.
We found risk was appropriately managed and addressed to minimise the risk of possible harm. When risks had been identified we saw good practice guidance had been referred to, to promote safe and effective practice.
People were consulted with about all aspects of their care and support. We saw one person and their family member had written their own care plan based upon their life history, likes and preferences. This had been incorporated into the person’s care record.
The registered manager worked proactively to ensure individual concerns were identified and acted upon before they became a complaint. People told us they had never had any reason to complain but were confident any complaints would be dealt with effectively and professionally should they ever need to.
We saw evidence of multi-agency working to meet people’s health care needs. The registered manager said they were proud of the relationships they had developed with members of the multi-disciplinary team.
Rating at last inspection:
Good (16 July 2016)
Why we inspected:
This was a planned and scheduled inspection.
Follow up:
The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Marches Home Care provides personal care for people in their own homes. At this inspection they were providing support for 27 people.
A registered manager was in post and present during our inspection. 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.
People were safe as staff had been trained and understood how to support people in a way that protected them from danger and abuse. Staff had access to detailed care plans and risk assessments and were aware of how to protect people from harm.
The provider completed appropriate checks on staff before they started work to ensure they were safe to work with people. People received help with their medicines from staff who were trained to safely support them.
People received care from staff who had the skills and knowledge to meet their needs. Staff attended training that was relevant to the people they supported and adapted to meet specific requirements.
Staff were supported by the provider and the registered manager who promoted an open and transparent culture. Staff received regular one on one support sessions with a senior staff member.
People were involved in decisions about their day to day care. When people could not make decisions for themselves staff understood the steps they needed to follow to ensure their rights were upheld.
People’s likes and dislikes were known by staff who supported them in a way which was personal to them. People were supported by staff who had positive relationships with them. People were involved in their own care and information was given to them by staff in a way they could understand.
People’s independence was encouraged and staff respected their privacy and dignity. People had access to healthcare when needed and staff responded to any changes in need promptly and consistently.
People and staff felt able to express their views to the management team and felt their opinions mattered. The provider and registered manager undertook regular quality checks in order to drive improvements. The provider engaged people and their families and encouraged feedback. People felt confident they were listened to and their views were valued.
Is the service caring?
Is the service responsive?
Is the service safe?
Is the service effective?
Is the service well led?
This is a summary of what we found-
Is the service safe?
People were treated with respect and dignity by the staff. People told us they felt safe. Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.
Risk assessments had been undertaken and safe systems of work developed. This reduced risks to people who used the service and staff.
Staff had received appropriate professional development and were able to obtain further relevant qualifications. Staff wore uniforms and carried identification badges. This meant people's safety was maintained.
Procedures were in place for the management and administration of medicine. Care records identified the level of support people received with medication. Most staff had received medication training. This ensured that people were kept safe and their needs met.
Is the service effective?
People's health and care needs were assessed. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People and relatives we spoke with understood what a care plan was and confirmed they had a copy in their homes.
The service had a policy for The Mental Capacity Act 2005. However, it was not clear how the service recorded mental capacity assessments and any subsequent best interest decisions.
People's needs were taken into account with times of visits. People we spoke with told us that staff were usually on time. If staff were going to be late the office would contact them to let them know. People we spoke with told us they felt staff had the skills and knowledge to meet their needs.
Is the service caring?
People were supported by kind and attentive staff. People commented, 'Staff are good', 'I would let them [managers] know if I am not happy with staff' and 'Staff are caring'.
People we spoke with confirmed that managers visited them to conduct a quality assurance survey. People we spoke with said, 'I'm very happy with the service', 'It's fantastic' and 'They are very good'. The feedback we saw was positive.
People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
We saw records that showed the service responded quickly to people's change in need. This was also confirmed by people we spoke with. People were able to express their views and these were acted on. People were supported to maintain their independence in their homes.
All people and relatives we spoke with knew how to raise a concern or make a complaint if they were unhappy. One person told us concerns they had raised had been dealt with by the registered manager People told us that they had no complaints and were happy with the care they received.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff felt supported in their roles through training, staff meetings, supervision and regular newsletter. Staff felt their views were listened too.
The service had a quality assurance system. Senior staff conducted regular observations of staff to ensure people received a safe quality service. Records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.
People told us they thought the service was well led. One person said, 'Yes, it is definitely well led'. Another person said, 'If I have any complaints I tell the manager and they are dealt with. The managers do a good job'.
We found that people were pleased with the service they received. They had been involved with the planning of their service and felt able to raise any concerns should there be a problem. They found the care staff kind, helpful and reliable. Senior staff checked with them that things were going well.
Each person had a care plan that told staff how to meet the person's support needs. These were put in place before the service started and kept under review.
We looked at a sample of recruitment files. These showed that appropriate checks were carried out before staff began work.
We found that care staff were given appropriate induction and training and supported to learn the job. The manager and owner had systems in place to monitor the quality of the service and how care staff were performing.
We saw records of compliments received by the service in the last year. Examples of comments included, 'extremely happy with the care providers', 'both of my current carers are good cooks', 'thank you for the wonderful service you provided to our father, your hard work, humour and devotion has touched us all, from individual actions to the group as a whole and its professional attitude'.
One person using the service told us, 'the introduction to the service was good, there was a brochure and the support plan was agreed with me. There were a few little things at the start but these were easily ironed out. I have had very good care with consistent carers who seem well trained and have the right attitude'.
We found that people who use the service understood the care and support choices available to them. They had signed their service agreement and where appropriate an agreement for care staff to administer their medicines. The care plans included reminders to staff to promote people's independence and what their likes and dislikes were. People had been consulted regularly to check they were satisfied with the support provided.
We found that people generally found the care workers polite, kind and respectful towards them and they respected their dignity whilst they assisted them. When concerns had been raised about the conduct of care workers the registered manager had taken these seriously and taken action.
We found that people's needs were assessed and care was planned and usually delivered in line with their individual care plan.
We looked at how the service was provided to three people to see if their needs had been met. The information about people's practical, physical and moving and handling needs was very clear. In some cases there was more information in the care needs assessment than in the care plan about people's mental health needs such as dementia.
The people we spoke to told us they trusted the care staff that came into their homes.
We looked at a sample of recruitment files. These showed that appropriate checks were carried out before staff began work including a reference from the previous employer and a criminal records check.
The people using the service that we spoke with said they had a small team of staff who regularly supported them. Sometimes because of short notice sickness other staff filled gaps in their rota but they usually knew these carers too.
The relative of one person who uses the service told us, 'My mother does not like having different carers. The agency does try to keep to two or three regular carers which helps her. They treat her with respect and do what is needed. The office staff are helpful and communicate with me if there are any concerns'.
We saw the training chart used to help monitor each worker's training needs. This showed that suitable training was provided to care staff. The three care staff we spoke with said the training was helpful and suitable for their role.
The people we spoke with had felt able to raise a concern to carers or with office staff if they needed to. They had been given a brochure that included information about the complaints procedure.
Systems were in place to monitor the quality of the service. These included surveys, support visits, telephone or face to face reviews and quality assurance assessment visits. A chart was being kept to show when each person had been contacted for their views and which method had been used. The chart showed a high level of contact in 2012. Surveys had been sent out to most people using the service in February 2012.