Background to this inspection
Updated
29 June 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 inspection was undertaken by one inspector and an Expert 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.
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 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 27 May 2021 and ended on 2 June 2021. We visited the office location on 27 May 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all of this information to plan our inspection.
During the inspection
We spoke by telephone with seven people who used the service and three relatives, about their experience of the care provided. We spoke with eight members of staff including the provider’s regional manager, registered manager, care coordinator and care workers.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one professional who regularly works with the service.
Updated
29 June 2021
About the service
Meridian Health and Social Care is a domiciliary care agency providing personal care to adults living in their own homes and flats. At the time of inspection, the service was supporting 75 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Processes were in place to monitor the safety and quality of the service. However quality assurance checks had not highlighted the issues found during this inspection regarding medicines records, recruitment checks and reporting of some incidents to CQC.
People told us they felt safe with the care they received from staff. Effective risk assessments and systems were in place to keep people safe from abuse or avoidable harm. The management team and staff understood their roles and responsibilities for raising and sharing any concerns with professionals. We found two concerns had not been notified to CQC as the management team were unclear about some notifiable incidents. We have made a recommendation about this.
People’s health needs were assessed before starting with the service. People received care from staff who knew them well and who were trained to support people safely. Infection control processes were in place and staff had access to adequate supplies of PPE.
People told us they received their medicines as prescribed. Some people’s medicines records had not been completed correctly in line with national guidance and the provider’s medication policy. The provider’s quality monitoring processes had not identified these. We have made a recommendation about this.
Recruitment processes were in place to ensure only appropriate staff were employed to work with vulnerable people. Some gaps were found in people’s employment history records which had not been found, either during the recruitment process or the provider’s quality monitoring processes. We have made a recommendation about this.
We received mixed views from people and staff regarding whether there were enough staff employed to support people. The provider has an ongoing recruitment process in place.
People were supported by staff to eat and drink enough to maintain a healthy lifestyle. Where necessary, staff referred people to their GP and other medical professionals to make sure people were supported to remain well.
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 and their families told us they were involved in the decisions made about the care they received.
Staff supported people in a friendly and respectful way. People and their relatives were complimentary about the staff and their caring attitude. People were encouraged to be as independent as possible. People received care which was centred around not only their needs, but also their wishes and choices. Care plans were reviewed regularly or as people’s needs changed.
People knew how to make a complaint, although no formal complaints had been made to the service. There was an effective complaints process in place to deal with any complaints that might be raised in the future. The management team worked in partnership with people, their families and other people involved in their care, for example other health professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service has changed provider. This service was registered with us on 12 October 2020 and this is the first inspection.
Why we inspected
This was a planned inspection to assess the standard of care delivered by the service and award a rating.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.