Archived: Merseyside Branch Office

Updated 9 October 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 was 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.

This unannounced comprehensive inspection was carried out on 29 and 30 August and 3 September 2018. This inspection was carried out by three adult social care inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

At the time of our inspection the service provided personal care to 135 people living in their own homes in the Merseyside area.

Before our inspection we reviewed the information we held about the service. We looked at the statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the local authority to gather their feedback about the service, who told us they did not have any concerns. We used this information to plan how the inspection should be conducted.

During the inspection we met and spoke with 21 people supported by the service and 8 of their relatives. We visited some people at their homes with staff and spoke to others by telephone. We spoke with 17 members of staff who held different roles within the service. This included the manager, team leaders and support workers. We also spoke with a healthcare professional who was visiting one of the people supported by the service.

We looked at a range of documentation at the service’s registered office in Speke and at the provider’s head office in Prescot. This included 13 people’s care records, medication records, 10 staff recruitment files, staff training records, accident and incident records, health and safety records, safeguarding and complaints records, audits, policies and procedures and other management records.

Updated 9 October 2018

This unannounced comprehensive inspection was carried out on 29 and 30 August and 3 September 2018.

Merseyside Branch Office is a supported living service which is run by Alternative Futures Group Limited. The service is registered to provide personal care to older people, people with learning disabilities and/or mental health needs.

At the time of our inspection the service was providing personal care to 135 people living in their own homes, in order to support them to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for people supported in their own homes; this inspection looked at people’s personal care and support.

The service did not have a registered manager in place at the time of the inspection. However, a new manager had been in post for several months and was in the final stages of registering with CQC. 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 care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

During our inspection we found that the service did not have clear records to specifically identify the people they provided the regulated activity of personal care to, as the records included information about all of the people the service supported. This lack of clarity had undermined the accuracy of notifications provided to CQC, which hampered our monitoring of the service. We discussed this with the manager who acknowledged that they had identified this problem and work was underway to review and confirm the people receiving personal care from the service. Shortly after our inspection the manager confirmed that this work had been completed and they now had accurate records relating to the people in receipt of personal care.

We found that the service had systems in place to protect people from abuse. Staff we spoke with were knowledgeable about the different types of abuse and knew how to raise concerns if necessary. The records we reviewed showed that safeguarding concerns were promptly and effectively managed by the service. The service was also meeting its obligation to notify CQC of any safeguarding concerns.

We reviewed people’s care files and found there were personalised risk assessments in place and these were reviewed regularly.

Medication was correctly administered and recorded by staff who had appropriate training and experience. The staff we spoke with told us that they were confident managing people’s medication and people received the right medication at the right times. The people we spoke with told us that they received their medication correctly and when they needed it.

Staff were safely recruited and were supported with an induction process. Criminal records checks, known as Disclosure and Barring Service (DBS) records, were carried out. We also saw that official identification, such as a passport or driving licence and verified references from the most recent employers were also kept in staff files. This ensured that the staff the service recruited were safe, suitable and competent to work with vulnerable people.

The service had accident and incident recording processes in place. The records we reviewed were well-maintained and up-to-date. Accidents and incidents were carefully monitored by a person employed as a risk and governance lead. This enabled the manager and senior staff to safely identify and manage any trends and ensured that risks were being safely managed.

Some of the staff we spoke with raised concerns about staffing levels in some of the places they supported people. We discussed these concerns with the manager, who explained that people’s changing needs were regularly reviewed in partnership with the local authority as were their commissioned packages of care. The manager also explained that as people’s independence increased their levels of support were amended to reflect this. We saw evidence to confirm that people were receiving the amount of support from staff that had been commissioned.

Staff training records were up-to-date and there was a clear system to document, monitor and plan staff training. We saw that all staff had received training relevant to their roles. All new staff took part in an appropriate induction process to ensure they were able to safely and effectively fulfil their roles.

The Care Quality Commission as required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance in place for the staff in relation to the MCA. The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA). The registered manager had a good understanding of the MCA and all required documentation was in place.

All of the people and relatives we spoke with told us that the staff were very caring and supportive. They also told us that staff treated them with kindness and respect.

People had their needs assessed prior to being supported by the service. The information from this was used to create individual person-centred care plans and risk assessments. People, their relatives and any other relevant health and social care professionals participated in the development of the care plans.

The service had a range of systems in place to monitor and improve the quality of service being provided.

Staff had received training on infection prevention and control. This meant that staff and people were protected from the risk of infection being spread.