Archived: Manorcourt Home Care

Updated 23 March 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection team consisted of an inspector, an assistant 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. Our expert by experience’s area of expertise was the care of older people.

Service and service type: The provider is a domiciliary care agency. People receive a personal care service within their own home and it is the personal care that is regulated by CQC.

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 48 hours’ notice of the inspection visit because we needed to make sure someone would be available at the office to meet with us. Inspection activity started on 4 February 2019 and ended on 21 February 2019.

What we did: Before the inspection we reviewed the information we held about the service and the provider. This included notifications the provider had to send us by law and information we had received from members of the public about the quality of care being provided. We also requested feedback from the local authority who funded some people’s care provided by the service. All this intelligence helped us plan our inspection.

We spoke with 18 people and two relatives over the telephone for their feedback about the care being received on 4 and 5 February 2019. Three staff were contacted by telephone on 20 February 2019. We visited the office location on 21 February 2019 where we spoke with the registered manager, two care staff and staff who were responsible for planning people’s care visits and monitoring medicines. We also spoke with the operations director who represented the provider.

We looked at various records relating to the care that people received which included six people's care records and seven medicine records. We checked three staff recruitment and supervision files and the training that staff had received. We also looked at a range of records regarding how the registered manager and provider monitored the quality of care people received.

Updated 23 March 2019

About the service: Manorcourt Homecare is a domiciliary care provider based in the town of Swaffham in Norfolk. At the time of this inspection approximately 140 people received personal care support from the service.

People’s experience of using this service: At our last inspection of this service in October 2017 we found a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014. This was because some people had experienced either missed late or inconsistent call visits and did not see regular staff. Also, risks to people’s safety had not always been thoroughly assessed and systems in place to monitor people’s medicines had not always been robust. The provider sent us an action plan telling us what they were going to do to meet this regulation.

At this inspection we found that some improvements had been made and the provider was no longer in breach of this regulation. However, further improvements are required. The quality of care that people received from this service at the time of the inspection was mixed. The main areas that required improvement were as follows:

People did not always receive care that consistently met their needs and preferences. This was particularly in relation to the times they received their care visits. The provider was aware of this and therefore, more staff had been recruited to work for the service and the way people received their care visits was being reviewed. People’s feedback was mixed as to whether or not they could get hold of someone in the office when they wanted to.

The provider had systems in place to monitor quality such as regular audits but these had not always taken place as often as they should have done. This meant potential errors that had been made had not been identified and acted upon in a timely way to prevent people from the risk of receiving poor care. The registered manager was aware of this and had taken steps to improve the provider’s current monitoring systems.

Most people had received their care visits when they needed them. However, some had experienced missed visits which had resulted in an impact on them. We had been advised at our last inspection in October 2017 that the provider had recognised they needed to improve the way they monitored for missed and late care visits and were trialling new technology using electronic monitoring. However, this had still not been implemented some 16 months later for the benefit of people using the service.

Aspects of the service that were good were as follows:

People told us that they felt safe when the staff were in their home with them and the provider had ensured that systems were in place to protect people from the risk of abuse. Staff used good infection prevention techniques to protect people from the risk of the spread of infection.

The staff were well trained and their practice had been regularly assessed to ensure it was safe and appropriate. The provider had made sure that staff had been checked as having good character before they started working with people in their own homes.

Where the staff supported people to eat and drink and with their healthcare needs, this had been done to people’s satisfaction. The staff worked well with other health and social care professionals and organisations to ensure people received the care they required.

People received care from staff who were polite, kind and caring and who treated them with dignity and respect. Staff asked people for their consent before they provided care and where people were unable to provide their consent, staff acted in line with relevant legislation to up hold people’s rights.

Most people saw regular staff so they could build caring and trusting relationships with them. People had been involved in the planning of their care and could make choices about this. People received information about how to contact the service if they needed to.

There was an open culture where people and staff could raise questions or concerns without fear. The staff understood what was expected of them and enjoyed working for the service. Most that we spoke with felt listened to, valued and supported in their role.

Rating at last inspection: Requires Improvement (report published 20 March 2018).

Why we inspected: This was a planned inspection based on the period since the last report was published by CQC.

Follow up: When we next inspect the service, we will check whether the revised systems put in place by the registered manager and provider to monitor the quality of care have been embedded and are fully effective at monitoring the service people receive. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.