Archived: Manchester Home Care Associates Limited

Updated 28 April 2016

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.

This inspection took place on 7, 11 and 12 January 2016 and the visits were carried out by two inspectors. One day was spent visiting people in their own homes. Another inspector from the Care Quality Commission contacted people by telephone to find out their views of the service. Before the inspection the provider completed a Provider Information Return (PIR) . This is a form that requires the registered manager to give some key information about the service, what the service does well and improvements they plan to make.

Before our inspection we gathered and reviewed the information we held about the service, including the statutory notifications received since our last inspection. A notification is information about important events which the provider is required to send us by law. We spoke with commissioners of the service to gather their views of the care and service and contacted two health care professionals who had had recent involvement with the service.

At the time of the inspection, there were 137 people using the service which employed 130 members of care staff. We spoke to people who used the service, their relatives, and staff. We contacted five people who used the service and also met face to face with five more people and their relatives in their own homes to seek their views about the agency.

During the inspection we spoke with the registered manager, deputy manager, two care managers, a care co-ordinator, an assessor and seven care staff. We looked at 11 people’s care records, 5 personnel files, supervision records and staff meeting minutes. We looked at medicine administration records and records in relation to the management of the service such as checks regarding people’s health and safety. We also looked at staff recruitment, training records, compliments, quality assurance and audit records.

Updated 28 April 2016

We carried out an inspection of Manchester Home Care Associates on 7, 11 and 12 January 2016. The first day of inspection was unannounced.

Manchester Home Care Associates is a domiciliary care service providing personal care and support to people living in their own homes. The service also works closely with healthcare commissioning teams in supporting people who have complex healthcare needs or are at the end of their life. The hours of support vary depending on the assessed needs of people. Services may be required the same day as the referral is received and may only continue for a few days.

At the time of the inspection the service was supporting 137 people within the local community. We last inspected the service on 30 September 2014 where we found the provider was meeting 3 out of 4 standards inspected at that time. The service was non compliant in requirements relating to workers or staffing.

There was 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 2008 and associated Regulations about how the service is run.

People told us they received safe care, which was reliable and consistent on the whole. We were told where there were any problems with care this predominantly occurred duringt weekends. The service had sufficient staff to meet people’s needs, and people were given the time they needed to ensure their care needs were met.

We saw that people were protected from avoidable harm. During the inspection we checked to see how the service protected vulnerable people against abuse and if staff knew what to do if they suspected abuse. There was an up to date safeguarding vulnerable adult’s policy in place. Risks to people were assessed and risk management plans were in place. We found that the staff we spoke with had a good knowledge of the principles of safeguarding.

Staff were trained and competent to administer medication. Where errors had occurred the provider could evidence that these were quickly identified and appropriate action taken. The provider was not always recording when medication was administered which was contrary to their own internal policy. We identified this as a breach in the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014 relating to the management of medicines.

The service was working to the principles of the Mental Capacity Act, 2005 which meant that care staff supported people to make their own choices about their care. Before any care and support was provided and when appropriate, the service obtained consent from the person who used the service. In other circumstances the service would discuss the support package with their relative. We were able to verify this by speaking with people who used the service, checking people’s files and speaking to staff.

The service had improved recruitment processes which included the completion of pre-employment checks prior to a new member of staff working at the service. This helped to ensure that staff members employed to support people were suitable and fit to do so. People who used the service could be confident that they were protected from staff that were known to be suitable to work with vulnerable people. Staff knew their roles and responsibilities and were knowledgeable about the risks of abuse and reporting procedures.

We saw evidence of the induction process, and there was appropriate training provided for caring roles and responsibilities, along with the “shadowing” of more experienced colleagues. Staff also signed to confirm they had read policies and procedures and that they were aware of the provider's requirements in respect of data protection and confidentiality. Supervisions were undertaken with some staff but these were inconsistent with timescales and content. We saw that examples of poor practice was identified during audits but there was no evidence that this was relayed to staff so that practice could be improved.

People were supported with a range of services which enabled them to continue to live in their own homes safely. Most of the people we spoke with who used the service and their relatives told us they had been involved in the assessment and planning of the care and support provided and that the service responded to changes in people’s needs.

The care records contained information about the support people required but were written in a task-orientated way. The documentation we saw concentrated predominantly on risk however the provider had recognised this and was in the process of implementing new person-centred care plans and risk assessments. The records we saw were complete and up to date.

We found people were receiving care from care staff who were deployed in a way that met people’s needs. Some people who used the service lived alone and staff required the use of a key to access their house. We saw that keys were appropriately stored in a ‘key safe’ outside a number of houses we visited and people receiving a service were satisfied with the way this was managed.

We found from looking at people’s care records that the service liaised with health and social care professionals involved in people’s care if their health or support needs changed. We saw care plans both at the office in people’s homes contained good information and instructions with regards to specialist equipment used by individuals. The service worked alongside other professionals and agencies in order to meet people’s care requirements and professionals we contacted were complimentary of the service.

There was an up to date accident/incident policy and procedure in place. Records of accidents and incidents were recorded appropriately within people’s care files.

The service had a complaints policy in place and we could see that people using the service were aware of how to make a complaint. Formal complaints were acknowledged and addressed within specified timescales. What wasn’t clear however was whether members of staff had been notified if a complaint directly involved them or what investigatory action had been taken if this was warranted.

Staff told us they felt they were able to put their views across to senior staff and to management and we saw examples of this from minutes of meetings and supervision records. The staff we spoke with told us they enjoyed working at the service and said they felt listened to and valued.

The service undertook audits to monitor the quality of service delivery. We saw a number of audits in place including medication audits and logs of spot checks on care staff completing visits. There was no evidence of any follow-up work as a result of bad or poor practice having been identified.

We found the service had up to date policies and procedures in place, which covered all aspects of service delivery including safeguarding, medication, whistleblowing, recruitment, complaints, equality and diversity, moving and handling and infection control.

The overall rating for this service is ‘requires improvement’. You can see what action we have told the provider to take at the back of the full version of the report.