Archived: Morecare at Home

We inspected this service on 23 May 2017. This inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived.

At our previous inspection on the 15 April 2015 the provider was meeting the regulations that we checked but we found that improvements were needed. This was because there were no recorded audits in place to regularly assess, monitor and improve the quality of care. At this inspection we found that recorded audits were in place to monitor the service and drive improvement. However further improvements were needed to ensure people’s human rights were protected.

Morecare at Home provides personal care to people in their own homes. At the time of our inspection a total of 73 people were using the service, of these 55 people were in receipt of personal care support.

The service had 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.

Where people needed support to make decisions, their capacity had not been assessed to ensure that it was clear why they could not make specific decisions. Consideration had not been made where people may be deprived of their liberty to ensure their human rights were upheld.

People received their calls as agreed and from a consistent staff team. People were protected from abuse as staff understood what constituted abuse or poor practice and their role in reporting concerns. Checks on staff were done before they started work to ensure they were suitable to support people. Medicines were managed safely and people were supported to take their medicine when needed.

People were supported by staff that received training to develop their skills and safely support the people they worked with. Staff were provided with supervision by the management team to monitor their conduct and support their professional development. When needed, people were supported to maintain their dietary requirements and preferences and to access healthcare services.

People felt that staff were kind and caring. People confirmed that the staff treated them with respect and ensured their privacy and dignity was upheld. The provider sought the opinions of people and their representatives to bring about improvements. People knew how to complain and we saw when complaints were made these were addressed. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement. The provider understood their responsibilities around registration with us.

We found a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We saw that care plans were person centred and individualised, the front of the plan included mini pictures of each person's main interests. This gave staff an immediate reminder of what they might talk with the person about during their visit.

We asked the service about the way it cooperated with other providers. We were told that they were proactive in asking for professional support, the people who used the service and staff we spoke with confirmed this.

We asked people who used the service and the staff about methods the agency used for control of infection. We were told by staff and people who used the service that staff wore aprons and disposable gloves when required. Staff also told us that they changed their uniforms at the completion of every set of visits (known as the morning, afternoon or evening "run").

We saw that the agency had an up to date training matrix. Staff confirmed that they had received suitable and sufficient training to confidently care appropriately for people who used the service.

The service took steps to monitor and improve the quality of the service it offered. Staff, records and the views of people were audited and improvements had been made where required.

We found that people were given helpful information, and were encouraged to ask questions before they chose to use the service. One person who used the service told us, "I interviewed them first. They were able to provide good answers to my questions".

The people we spoke with told us that they received good care, which met their individual needs. The staff were knowledgeable about the people they cared. One member of staff told us, "We are expected to deliver good care and our team leader makes sure we do".

We found that the agency had plans in place for all staff to complete safeguarding training as soon after commencing work as possible. We saw that the agency had taken suitable steps to protect people who used the service from the risk of abuse. The provider told us, "We don't employ people who do not have clear background checks".

We saw that the agency took suitable steps to ensure that they had sufficient staff with suitable skills to support the needs of the people who used the service. One person who used the service told us, "They never rush me".

We found that the agency learnt from events and applied this learning to the way it planned and delivered the service. We saw that suitable monitoring was place to assess the quality of the care the agency provided.