Mulholland Care Limited

Updated 31 January 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 checked 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.

This inspection site visit took place on 14 December 2017 and was announced. We gave the agency 72 hours’ notice of the inspection visit because the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in. We visited the office to see the registered manager and office staff; and to review care records along with policies and procedures. With their consent, we visited three people in their own homes on 29 December 2017. Inspection site visit activity started 12 December 2017 and ended on 4 January 2017.

This was a routine comprehensive inspection carried out by one adult social care inspector.

We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. This included previous inspection reports, safeguarding alerts and statutory notifications. A notification is information about important events which the service is required to send us by law.

We met and spoke with the registered manager, operations manager, human resources manager and service manager. Following the inspection, we spoke with a further ten people, three relatives and received feedback from 15 care staff. We also received feedback from three health and social care professionals and one commissioner.

We reviewed information about people’s care and how the service was managed. These included: three people's care files and medicine records; three staff files which included recruitment records of the last staff to be appointed; staff rotas; staff induction, training and supervision records; quality monitoring systems such as audits, spot checks and competency checks; complaints and compliments; incident and accident reporting; minutes of meetings and the most recent quality questionnaire returned.

Updated 31 January 2018

The inspection took place on 14 and 29 December 2017 and was announced.

Mulholland Care is registered with the Care Quality Commission (CQC) as a domiciliary care provider. It provides personal care to a range of older adults and younger adults living in their own houses and flats in the community. These included people living with dementia, a mental health illness or a learning disability.

At the time of inspection, there were 87 people receiving a service from the agency. Although the majority of people using the agency received a regulated activity, some received support visits only. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The agency provided an overall number of 840 care hours each week. The time of care visits ranged from a minimum of 15 minutes to a maximum of one and quarter hours, with the frequency of visits ranging from three times a week to 28 times a week. There were 38 full and part-time staff employed.

There was registered manager in post. A registered manager is a person who has registered with the CQC 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 last inspection, the service had an overall rating of good; safe, effective, caring and responsive were good and well led required improvement.

At this inspection, we found the service remained with an overall rating of good. The service had improved in the well led domain which was now good, along with the four other areas.

The registered manager and care workers provided people with a service and delivered care and support which took into account people’s individual choices and preferences. People were very happy with the service they received. Care workers treated people with respect, dignity and compassion at all times. People were encouraged to be as independent as possible.

Meaningful relationships had developed between staff, people and their relatives. Friends and family were involved in people’s care and spoke positively of the agency. People usually had a regular team of care workers, but on occasions received support from care workers they were unfamiliar with. People’s health needs were monitored and relevant professionals contacted when necessary.

People were kept safe by care workers who were safely recruited, well trained and received supervision. They enjoyed their jobs and felt valued by management.

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. Care workers had received training on the Mental Capacity Act 2005 and were aware of how it applied to their practice.

Each person had risk assessments and a care plan in place. However, these had been identified by the management team as requiring updating to include all the information needed. People and their families were involved in the planning of their care and these were regularly reviewed. When changes in care support were required, amendments were carried out in a timely way.

Care workers had been trained to give people their medicines safely and ensured medication administration records were kept up to date. Care workers supported people to eat a nutritious diet with food and drinks of their choice. In between care visits, care workers always made sure people had snacks and drinks available.

There had been a reorganisation of the management structure. Each member of the management team had a clear definition of their roles and responsibilities. People were confident any issues would be dealt with appropriately. There was a complaints policy and process in place, but this needed updating with details of who to contact if necessary. The service worked in close partnership with other relevant organisations to benefit the people they supported.

Effective systems were in place to continually monitor and improve the service. Regular auditing took place and feedback was regularly sought from people and their relatives to gain their experiences of the service.