Background to this inspection
Updated
2 December 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The service was inspected by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed all of the information we held about the service. This included notifications submitted to us relating to accidents, incidents or safeguarding concerns.
We had also carried out a direct monitoring call with the registered manager on 16 September 2021. As part of this monitoring approach we spoke with six people, one relative and nine staff. We also received feedback from a social care professional and one person receiving care.
We used all of this information to plan our inspection.
During the inspection
We received supporting evidence prior to our site visit which included staff rota’s, medicine administration records and governance information.
We spoke with three people and a further three members of staff we well as the registered manager, care coordinator, care director and regional manager.
We reviewed a range of records. This included 10 people’s care records and medicines records. We looked at four staff files in relation to recruitment and staff supervision. We also reviewed a variety of records relating to the management of the service which included staff training information.
Updated
2 December 2021
About the service
Mayfair Homecare Surrey is a domiciliary care provider, providing personal care to people living in their own homes. This included people who were elderly and frail, had specific health needs or were nearing the end of their life. Not everyone using Mayfair Homecare Surrey received a regulated activity. 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 consider any wider social care provided. At the time of our inspection, 64 people were receiving support with the regulated activity from the agency.
People’s experience of using this service and what we found
People told us although staff were kind and caring, their experience of the agency as a whole had deteriorated recently. They said staff were late, care visits’ times changed without notice, visits were cancelled and some people had been given notice by the agency. People reported staff were unhappy and leaving, which meant they were losing staff who had got to know them. One person told us, “They cancel my calls at the last minute.”
Although people received their medicines as prescribed, records in relation to these were not well maintained which meant the agency could not safely say people always received the medicines they required in line with their prescription.
The agency had merged with another branch and taken over an additional domiciliary care agency. Following this, many staff had left which had resulted in staff shortages, additional workload for remaining staff and staff feeling demoralised. This had been noticed by people receiving the care. One person said, “Some carers who come to me are actively looking for new employment opportunities elsewhere.”
People were involved in their care and made their own decisions and some people said their individual needs were met. They told us staff respected them and helped them remain independent. People said staff always wore appropriate personal protective equipment when attending their calls and they felt staff were competent in their role.
Records in relation to people’s care were detailed and contained information for staff to enable them to respond to people’s needs. Staff recognised where they needed to change their response to meet people’s communication needs and what people’s likes or dislikes were, for example in relation to their food.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People told us they knew how to raise a concern or a complaint and said these were responded to. People were regularly asked for their feedback on the quality of care they received. Where negative feedback was received, the agency acted on this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service under the previous provider was Good (published 23 May 2019).
Why we inspected
The inspection was prompted in part due to the feedback we received through our direct monitoring approach. Staff told us there were insufficient staff available to carry out care visits. People told us their visits were being cancelled at short notice. We also heard that for a period of time during September 2021, people did not have medicine record in their homes for staff to sign when medicines had been given.
We also planned this inspection, as the service has not been inspected since the change of provider in May 2020.
Although we found no evidence during this inspection that people were at immediate risk of harm from the concerns we had received, we did find that the provider needs to make improvements. Please see the Safe, Responsive and Well-led sections of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to staffing levels, medicines practices, responsive care and governance. You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.