Archived: Mears Homecare Limited - Chiswick

Updated 17 March 2017

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 7 and 8 January 2017. The first day of our visit was unannounced and we told the provider we would be returning the next day to complete our inspection.

The inspection was carried out by a single inspector and an expert-by-experience undertook telephone interviews with people and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert for this inspection had experience of caring for older people.

Prior to the inspection we reviewed the information we held about the service and notifications we had received from the provider. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about.

During the inspection we looked at records, including 12 people’s care plans, seven staff records, medicine administration records and records relating to the management of the service. We spoke with 15 people who used the service, the registered manager, the manager, the project manager, two care coordinators and a visiting officer.

We also received feedback by email from four care workers and spoke by telephone to a further two care workers employed at the service.

Updated 17 March 2017

This inspection took place on 7 and 8 February 2017 and was announced. We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available. The service was registered with the Care Quality Commission on 9 February 2016 and had not been inspected before.

Mears Homecare Limited – Chiswick is a domiciliary care agency which provides personal care for people in their own homes. At the time of our inspection, approximately 300 people were receiving care, all of whom were funded by the local authority.

People who received a service included people living with physical frailty or memory loss due to the progression of age and people living with a learning disability. The frequency of visits varied from one to four visits per day depending on people’s individual needs.

There was a registered manager in post at the time of our inspection. 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 risks to people’s wellbeing and safety had been assessed, and there were plans in place for some of the risks identified, however, these lacked details and clear instructions for staff to follow.

The service did not employ enough staff to meet people’s needs safely and had received a large number of complaints and safeguarding concerns mainly relating to missed visits and lateness. However they were undertaking a large recruitment drive to reduce this issue. They also used a reliable agency who provided regular care workers to the service.

There were systems in place for the management of people’s medicines and the visiting officers undertook audits in people’s homes, however these were not regular, and where errors were identified, there was no written evidence of any action taken.

Feedback from people and their relatives was mixed. Some people said that care workers were often late and did not always inform them of this. Some people reported missed visits and were dissatisfied with the service. Some people said they had different care workers visiting which made it difficult for them to build a rapport and get to know them. However, all of them said their regular care workers were reliable and caring and that they trusted them.

We made a recommendation in relation to the recording and reporting of accidents and incidents.

There were no records of any accidents and incidents. We were told that care workers did not complete reports if they had not witnessed an accident or incident.

Risk assessments and support plans were not always updated after a review, and when they were updated, the information was sometimes incorrect and did not reflect the person’s needs.

Although care and support plans were written from the person’s perspective, they lacked person-centred details and it was difficult to get a ‘picture’ of the person and their individual needs by reading these.

We made a recommendation in relation to person-centred care planning

People’s health and nutritional needs had been assessed, recorded and were being monitored. However, records did not always provide enough information for care workers.

There were procedures for safeguarding adults and care workers were aware of these. Care workers knew how to respond to any medical emergencies or significant changes in a person’s condition.

People’s care plans did not contain information about Lasting Power of Attorney (LPA) and it was unclear, where people lacked capacity, how decisions were made on their behalf.

Care workers had received basic training in depth training in the Mental Capacity Act (MCA) 2005, and showed some understanding of its principles. Records showed that people, where able, had consented to their care and support and had their capacity assessed by the local authority prior to receiving a service from Mears Homecare - Chiswick.

People’s needs were assessed by the local authority prior to receiving a service and support plans were developed from the assessment. People using the service whom we spoke with said that they were happy with the care workers.

The provider carried out checks on new staff to make sure they were suitable to work in the service.

Care workers received regular training but were not regularly supervised and appraised, however records showed that this was improving.

Staff meetings were irregular but we saw that the provider was making improvements in this area.

Care workers received induction training and shadowed experienced colleagues before delivering care and support to people.

There was a complaints procedure in place which the provider followed. We saw evidence that the provider took every complaint seriously and carried out the necessary investigations in a timely manner.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to the risk assessment, staffing, mental capacity assessment, supervision of staff, records and monitoring the quality of the service provided. You can see what action we told the provider to take at the back of the full version of this report.