Archived: Mears Homecare Limited - Hillingdon

Updated 15 September 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 the 29, 30 June and 1 July 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

The inspection was carried out by one inspector and an expert-by-experience carried out telephone interviews of people who used the service and relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who has used this type of care service. The expert-by-experience at this inspection had personal experience of caring for people who had dementia.

Before the inspection we reviewed the notifications we had received from the service, records of safeguarding alerts and previous inspection reports.

During the inspection we spoke with the manager, operations manager and four care workers. We reviewed the care records for 10 people using the service, the employment folders for nine care workers, the training records for all the care workers and records relating to the management of the service. After the inspection visit we undertook phone calls to 10 people who used the service, two relatives and received feedback via email from four care workers.

Updated 15 September 2016

We undertook an announced inspection of Mears Homecare Limited – Hillingdon on 29, 30 June and 1 July 2016. We told the provider two days before our visit that we would be coming because the location provides a domiciliary care service for people in their own homes and senior staff might be out visiting people.

Mears Homecare Limited – Hillingdon provides a range of services to people in their own home including personal care. At the time of our inspection 300 people were receiving personal care in their home. The majority of people using the service had their care funded by their local authority. People could also pay for their own care.

At the time of the inspection the manager was in the process of being registered with the Care Quality Commission. 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.

At our last comprehensive inspection of this service on 30 November, 1 and 3 December 2015, we found breaches relating to the registration of the manager, need for consent, safe care and treatment, receiving and acting on complaints, good governance and staffing. As a result of these, our concerns were sufficiently serious for us to impose a condition on the provider's registration to restrict admissions to the service based on our concerns in relation to staffing issues and we rated the service as overall inadequate and consequently placed into special measures. At this inspection, we found improvements had been made in this area and we have therefore asked the provider to request that this restriction is now lifted.

We also imposed positive conditions in relation to the provider providing us with regular updates on their progress in addressing the breaches we found with Regulations 12 (safe care and treatment) and Regulation 17 (good governance). At this inspection, we found there were continued breaches of Regulations 12 and 17 and we therefore decided to continue with the positive conditions for these breaches. Because we are continuing previous enforcement action, this has not been reported upon at the back of this report.

At this inspection, we also found a repeated breach of Regulation 11 (need for consent). Because this did not form part of the enforcement action we took after the previous inspection, we have reported on this breach at the back of the report where you can see what action we have told the provider to take.

The provider sent us an action plan identifying the actions they would take to improve the service and we received monthly feedback on the audits that were completed.

There were generic risk assessments in place but these did not identify the possible risks in relation to specific issues for people. Care workers were not provided with guidance on how to reduce these specific risks for example where a person was living with depression or diabetes.

Although people told us they felt safe when they received care in their home, we found that the provider had not always ensured people were protected from the risks of receiving unsafe care. There was a procedure in place for the management of medicines but care workers were not recording the administration of medicines accurately. This meant the provider could not ensure medicines had been administered as prescribed. We have made a recommendation in relation to the administration of medicines.

The provider had a policy in place in relation to the Mental Capacity Act 2005. However, appropriate actions were not taken to assess people’s capacity to make decisions relating to their care and identify the support they required.

Care records relating to people using the service were not completed accurately to provide a current picture of the person’s needs and support provided. This did not provide up to date information for care workers in relation to how and when people’s care should be provided.

Improvements had been made in the recording and investigation of accidents and incidents since the previous inspection. We also found improvements had also been made in the number of care workers available to provide care.

Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.

People felt the care workers were caring and treated them with dignity and respect as well as supporting them to maintain their independence while providing care.

There were improvements in the way complaints were investigated and responded to since the previous inspection.

People using the service had been sent a questionnaire asking for feedback on the quality of the service and the comments received had been positive.

Since the previous inspection the provider had introduced a range of systems to monitor the quality of the service provided.

Care workers felt they were supported to carry out their role and the service was now well-led.

Following our last inspection, we placed the service in special measures. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. As the provider has demonstrated improvements and the service is no longer rated as inadequate for any of the five questions, it is no longer in special measures.