Archived: Mears Homecare Limited DCA (Sheffield)

Updated 30 June 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 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 took place over three days on 14, 15 and 18 April 2016.

We usually ask the provider to complete a Provider Information Return (PIR). This is a document that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. On this occasion we did not ask the provider for a PIR as the inspection was moved forward due to concerns received.

Prior to the inspection we reviewed information we held about the service. We looked at previous inspection reports and the notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

Prior to our inspection, we spoke with the local authority to obtain their views of the service.

The inspection team was made up of four adult social care inspectors.

We visited and spoke with six people who were support by Mears Homecare Limited DCA (Sheffield) in their homes and four of their relatives. We also saw any care records which were kept at people’s homes. We looked at two further care records during the visit to the agency’s office.

During the inspection we contacted 23 people who were supported by the service. We were able to speak over the telephone with 11 people supported by the agency and one relative about the service they were provided with. We contacted Mears Homecare Limited DCA (Sheffield) staff and were able to speak over the telephone with eight care workers about their roles and responsibilities. We spoke with a further four care workers during visits to people’s homes. We visited the office and spoke with the regional director, the manager, the recruitment officer, the complaints manager, field care supervisors and care coordinators. We viewed records relating to the running of the agency, which included staff training records, audits, complaints records and written policies and procedures.

Updated 30 June 2016

The inspection took place on 14, 15 and 18 April 2016, and was an announced inspection. The manager of Mears Homecare Limited DCA (Sheffield) was given 48 hours' notice of the inspection. We did this because we needed to be sure that the manager and some office staff would be present to talk with.

Mears Homecare Limited DCA (Sheffield) is a domiciliary care service. The agency office is based in the S4 area of Sheffield. They are registered to provide personal care to people in their own homes throughout the city of Sheffield. At the time of our inspection the service was providing personal care for 436 people. There were approximately 123 staff employed by the agency.

Mears Homecare Limited DCA (Sheffield) was known under the name of Care UK DCA (Sheffield) until August 2015 when the provider changed the agency name.

The service was last inspected on 6, 9 and 10 March 2015 and was found to be in breach of five of the regulations we inspected at that time. People were not protected against the risks associated with medicines because some people were not supported safely with their medication. People did not always receive person centred care and treatment that was appropriate and met their identified needs. People employed by the service did not receive appropriate supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. Adequate systems were not in place to ensure an accurate and contemporaneous record in respect of each service user was maintained. Adequate systems were not in operation to assess, monitor and improve the quality and safety of the services provided in the carrying on of the regulated activity. The provider sent a report of the actions they would take to meet the legal requirements of these regulations, which stated they would be compliant by 31 October 2015. We checked whether these regulations had been met as part of this comprehensive inspection.

It is a condition of registration with the Care Quality Commission that the service has a registered manager in place. 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. The manager had been in post since January 2016 and had applied to register with us.

Significant changes to the staffing at Mears Homecare Limited DCA (Sheffield) had occurred since our last inspection. The previous registered manager and area manager had left the agency and some care workers had also left. In addition, high levels of staff sickness had impacted on the running of the agency. The provider had put additional staff and systems in place to support the on-going improvement of the service.

All of the staff and most people spoken with reported improvements to the agency in recent weeks.

People spoken with said they had regular care workers that they knew well. People told us their regular care workers were kind, caring and considerate. They told us they felt safe with their regular care workers. When their regular care workers were not available people told us the service was not as reliable.

The provider did not have adequate systems to ensure the safe handling, administration and recording of medicines to keep people safe.

Staff recruitment procedures were thorough and ensured people’s safety was promoted. The provider had undertaken all the checks required to make sure people who were employed at Mears Homecare Limited DCA (Sheffield) were suitable to be employed.

Whilst the provider used agency staff to cover visits until permanent care workers were recruited, people did not have their needs met by sufficient numbers of suitably deployed staff which resulted in some missed visits.

Some staff did not receive regular supervisions or appraisal.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role.

People’s care plans contained information on the support needed and risks to the person so that important information was provided to ensure people’s identified needs could be met.

Most people felt staff were caring and respected their privacy and dignity. However there were examples where this was not the case.

Some people felt complaining did not improve the service they received as any concerns they raised weren’t responded to or acted upon. People told us they did not always get a response when they telephoned the agency office.

There were some systems in place to assess and monitor the quality of service provided. The provider had an improvement and action plan that showed audits had taken place to measure improvement and identify further actions needed to continue improvements. The provider’s action plan identified gaps in some audits.

We found seven breaches in five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in; Regulation 10: Dignity and respect, Regulation 12: Safe care and treatment, Regulation 16: Receiving and acting on complaints, Regulation 17: Good governance and Regulation 18: Staffing.

You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.