MD Care Ltd

Updated 22 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the service 48 hours notice of the inspection visit because the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The inspection was carried out by one inspector and one expert by experience. An expert by experience is a person who has experience of this type of service.

Inspection site visit activity started on 16 October 2018 and ended on 17 October 2018. We visited the office location to see the manager and office staff; and to review care records and policies and procedures.

We reviewed all the information we had available about the service, including notifications sent to us by the provider. A notification is information about notable events, which the provider is required to send us by law. We used this information to plan what areas we were going to focus on during our inspection. We also reviewed the information the provider had given us in their Provider Information Confirmation (PIC). This form asks the provider to give some key information about the service, what the service does well, and the improvements they plan to make. We also sought feedback from commissioners who had funded people to use the service and monitored the service. Where feedback has been provided this has been included within the report.

We looked at the care records of four people and four staff recruitment records. We looked at other information related to the quality of the service. This included quality assurance audits, training information, minutes of meetings with staff and arrangements for managing complaints.

We spoke to the two company directors, the registered manager and four members of staff. We also spoke with four people and four relatives.

Updated 22 November 2018

This inspection took place on the 16 October and 17 October 2018 and was announced. We spent one day at the office, and made telephone calls to people.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults. On the day of our inspection, there were 40 people using the service, all of which received personal care.

At the last inspection on the 20 March 2018, we rated this service as requires improvement overall. We found breaches in regulation under the Health and Social Care Act, 2008. This was because risk assessments were not always in place and people’s medicines were poorly managed. There were insufficient staff which affected the quality of care people received. People’s needs were not always assessed and care plans were not detailed. The provider did not have a robust governance processes in place to mitigate concerns about the safe running of the service.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions, safe, effective, caring, responsive and well led to at least good. At this inspection we found the registered provider had improved and was now good overall.

At the last inspection, the registered provider had struggled to recruit enough staff, which had affected, on the quality of care people received. At this inspection this had improved, and people told us staff arrived on time when they should have done and stayed for the agreed amount of time.

The service has 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.

Staff had a good understanding of how to manage medicines, and safeguarding matters. People's received their medicines in the right time and in the right way. There was enough staff available to ensure people's wellbeing, and safety. People told us staff turned up on time and stayed for the duration. A robust recruitment and selection process was in place.

People are 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.

Staff were kind and caring and had developed good relationships with people using the service. Relatives confirmed staff looked after people well. People were provided with the care and support, they needed to stay independent.

People were involved with care planning. Staff knew people well and were aware of their personal histories. People who used the service felt they were treated with kindness and said their privacy and dignity was respected. Positive relationships had developed between people and the staff that supported them. Information included guidance for staff so they could follow a structured approach when supporting people to live their day to day lives.

Surveys were carried out to seek the views of people who used the service. However, this information was not used to continuously improve the service and to make improvements. Spot checks, and care planning review meetings were carried out on a regular basis, but the audit process needed to be developed to ensure robust systems were in place, that monitored the quality of the service.

Further information is in the detailed findings below.