Marego Limited

About the service

Marego Ltd is a domiciliary care agency providing personal care to children, younger adults and older people living in their own homes. At the time of our inspection there were 12 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Right Support

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and those important to them were involved in planning their care. Staff focused on people's strengths and promoted what they could do, so people had a fulfilling everyday life.

Staff supported people to take their prescribed medicines and to access healthcare services where this was part of their care packages.

Recruitment of staff was safe and robust. We saw that pre-employment checks had been completed before staff could commence work.

Right Care

People received care from staff who were kind and compassionate. Staff protected and respected people's privacy and dignity.

People were supported by staff who had clear understanding of safeguarding and abuse. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so.

Risk assessments were in place which guided staff in caring for people in a safe way.

Right Culture

The registered manager and staff were open and transparent throughout our inspection and demonstrated their commitment to providing good quality care.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well.

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

Rating at last inspection

The last rating for this service was good (published 14 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

During the last inspection on 6 and 7 April 2016 we found the service was in breach of two legal requirements and regulations associated with the Health and Social Care Act 2008. These breaches related to compliance with the Mental Capacity Act (2005) and assessing risk.

Marego Limited is a domiciliary care agency based in North London which provides home based care for children and adults. At the time of the inspection, there were 22 people using the service, 19 of which were children. The service provides nursing and personal care, primarily to children with complex care needs. At the time of the inspection, the service was not providing nursing staff.

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.

At this inspection, we found detailed and up-to-date risk assessments were in place for people using the service. These explained the signs to look for when assessing the situation and the least restrictive ways of mitigating the risk based on the individual needs of the person.

Significant improvements had been made to ensure that consent to care was obtained from the appropriate person. The service had implemented a policy and training around mental capacity and obtaining consent.

We received positive feedback from relatives and health professionals regarding overall service provision, the caring nature of staff and the high standards of care delivered.

We found that care plans were person centred and reflected what was important to the person which enabled staff to deliver person centred care in line with people's preferences. Care planning was carried out in partnership with the person’s family.

We found that staff training, supervisions and appraisals were monitored and updated regularly. There was a comprehensive and on-going training programme. Staff had been trained in the use of specialist equipment prior to providing care for people. Staff were safely recruited with necessary pre-employment checks carried out.

Medicines were managed safely and effectively and there were regular medication audits in place. Staff had completed medicines training and had their competency to administer medicines assessed.

The service regularly requested feedback from people who used the service, to improve the quality of care people received.

People were encouraged and supported to access the community and engage in activities of their choice.

The management team enabled an open culture that encouraged staff to discuss issues and areas for improvement.

The provider had a quality monitoring system to ensure standards of service were maintained and improved.