Midcare Services Ltd

Midcare is a domiciliary care service. It provides personal care to people living in their own homes. On the day of inspection, the agency was supporting 30 people. There was 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.'

People's experience of using this service and what we found

The registered manager who is also the provider did not have appropriate systems in place for gathering reviewing and evaluating information about the quality of the service provided.

There was a complaints procedure to enable people to make complaints and people spoken with were aware of these procedures. People told us they felt that the registered manager and staff would address any concerns they had. We saw when complaints were made the registered manager did not always follow their own complaints procedure to ensure a full investigation was completed.

Recruitment checks were completed and included checks with the Disclosure and Barring Service. (DBS) to ensure staff were suitable to work with people. However, staff that required a visa to work in the UK were not always reviewed to ensure they continued to work within the law. The registered manager assured us that checks were made but had not recorded this. The registered manager assured us this would be documented in the future.

People told us they felt safe with the staff who supported them. People told us that staff were kind and considerate. Relatives spoken with told us that the staff were respectful.

People had support with their medication when required from staff. Staff had completed training in the safe administration of medication to ensure people were supported by experienced staff who had the right skills.

People had their care needs assessed to ensure the service could meet their needs. These included risks associated with people's care and how they wanted staff to support them.

Staff were aware of how to protect people from the risk of abuse and confirmed who they would report to if they had any concerns, including external agencies if required. People confirmed the care they received met their individual preferences and choices. Care plans were reflective of people's current needs.

People and their relatives told us that staff were very kind and caring and treated them with dignity and respect.

Rating at last inspection: The last inspection was completed on 30 March 2017 and was rated as Good. Published (27 April 2017)

Why we inspected: This was a planned inspection.

Enforcement: We have identified breaches in relation to the governance processes at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up: We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Midcare Services Ltd are registered to deliver personal care. They provide domiciliary care to younger and older adults living in their own homes, who may be living with dementia and/ or a physical disability. At the time of our inspection three people were receiving personal care from the provider.

The service had a registered manager. 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.

People were provided with support that was safe and protected them from harm. Assessments were undertaken to identify any issues that may put people using the service at risk and care staff were aware of these. The provider ensured consistency of the care staff supporting people. Recruitment practices were comprehensive and ensured as far as possible that staff employed were safe to work with people. People were supported effectively with their medicines.

Care staff had the skills and knowledge required to support people effectively. The provider ensured all new staff had an induction and their training prepared and supported them to work with people effectively. Care staff knew how to support people in line with the Mental Capacity Act and gained their consent before assisting them. Staff knew who to contact should they have any concerns about the health of the people they were supporting.

People’s preferences for how they wished to receive support were known and considered by care staff. People were involved in making decisions about their care and how it was to be delivered. Care staff provided support respectfully in a way that maintained people’s dignity. People were encouraged to maintain their optimum level of independence by care staff.

Care staff were knowledgeable about people’s needs and knew the importance of providing them with personalised care, that met their preferences. Care staff considered all aspects of people’s well-being when supporting them and knew how any more diverse needs should be met. People knew how to raise complaints or concerns and had confidence that the appropriate action would be taken.

People were happy with the support they received and felt the service was led and managed well. Care staff were well supported in their role. A culture of openness and support for all individuals involved in the service was promoted. The provider encouraged people to share their views about the care they received. The provider had all the necessary knowledge and systems in place to ensure the service provided was monitored regularly to check its quality and safety.