Archived: Manorcourt Homecare

Manorcourt Homecare is a domiciliary care service providing personal care to people in their own homes. 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. At the time of the inspection approximately 98 people were receiving personal care.

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

People had not always received their medicines correctly and the provider had not ensured that people’s consent had been obtained in line with the relevant legislation.

There were enough staff available to ensure people received their care visits and that they were safe. However, there were not enough to deliver care in line with people’s preferred call times as much as was practicable. People said staff were often late or their calls were at inconsistent times, particularly at weekends. This they said, affected their day and wellbeing. The registered manager had recognised this and was trying to recruit more staff to the service to improve this area.

The provider’s governance systems had not been robust at driving improvement within the service since our last inspection. Audits had not always been effective at identifying mistakes or concerns so they could be thoroughly investigated. The provider had recognised they did not have robust oversight and were introducing new systems to improve this in the new year.

Staff were kind and caring. However, the service had not been designed to ensure the care people received was fully person-centred or caring.

Staff had received training and supervision, but we found some issues with their competency in some areas. We have therefore made a recommendation the provider reviews how they assess staff practice.

People told us there was an open culture at the service where they could raise complaints without fear. Some people felt their complaints had not been listened to and the service did not always have records to show that people had complained.

Systems were in place to protect people from the risk of abuse. Most risks to people’s safety had been assessed and managed well. Staff took precautions to protect people from the risk of the spread of infection.

People received support to eat and drink enough to meet their needs and received assistance with their healthcare needs when required. The service worked well with other professionals.

Staff treated people with respect. They upheld people’s dignity and encouraged their independence. People’s end of life wishes had been captured and were respected.

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 Requires Improvement (published December 2018). The service remains rated Requires Improvement. This service has been rated Requires Improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches at this inspection in relation to the management of people’s medicines, consent, providing person-centred care and good governance.

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 from the provider to understand what they will do to improve the standards of quality and safety. We will also meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection around 100 people were using the service.

There was no registered manager working at the service. They had recently resigned from their 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. The service was being managed by the care manager who had been working for the service for several years. Their intention is to put in an application to register as the manager soon.

At the last inspection of Manorcourt Care Watton, we rated the service overall as good. We did however ask the provider to make improvements in some areas. These were in relation to being more responsive to people’s preferences regarding the times of their care calls and to ensure that all appropriate guidance was in place for staff to follow in relation to meeting people’s needs. At this inspection we found the required improvements within these areas had not been made. Therefore, the overall rating for the service had now been changed to requires improvement.

Systems were in place to protect people from the risk of abuse and there were enough staff to cover people’s care visits. No care visits had been missed within the last three months. Improvements had been made to staffing levels and the manager was actively looking to improve the scheduling of calls to meet people’s preferences with regards to the times they received them.

People were supported by staff who were kind and caring. They treated people with dignity and respect. Where supported with eating and drinking, the staff made sure people received enough to meet their needs.

The staff took good precautions to protect people from the risk of infection and people received their medicines when they needed them. The auditing of this area had recently improved.

Consent had been obtained from people in line with the relevant legislations and when required, they had been supported with their healthcare needs.

People had been involved in making decisions about their care and had access to information on how to complain. People gave us mixed views as to whether they felt listened to and their complaints dealt with to their satisfaction.

Staff had received enough training and supervision to provide people with effective care. They were happy working at the service and felt supported. There was an open culture where they and people could raise concerns without fear.

Although people were happy with most aspects of the support they received, some again told us their care calls were made at inconsistent times which had an impact on their lifestyle and wellbeing. People’s care needs had been assessed and in most areas, there was clear guidance for staff to follow so they could provide support that people needed. However, there was a lack of information in relation to how staff should deal with catheter, stoma and diabetic care which increased the risk of people receiving inappropriate care.

The provider’s governance systems had not been effective at ensuring that these areas had been improved adequately since our last inspection. Also, they had not identified that some incidents had not been reported or investigated appropriately. This was a lost opportunity to learn from incidents. There was a new manager in post. They had recently made some changes to the current systems used to monitor the quality of care people received which demonstrated some improvements. These now need to be consistently applied across the service.

Manorcourt Homecare is a service that provides personal care to people in their own homes. At the time of the inspection, 150 people were receiving care from the service.

There was a registered manager working at the service. 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 and associated Regulations about how the service is run.

People received care from staff who were kind and caring and who treated people with dignity and respect. The staff were well trained and the provider had systems in place to protect people from the risk of abuse. There were enough staff to meet people’s needs.

People received their medicines when they needed them and staff asked them for their consent before providing them with care. The staff acted within the requirements of the Mental Capacity Act 2005 when providing care to people who were unable to consent to it themselves.

People’s care needs had been assessed and were being met. However, staff sometimes did not provide care at people’s preferred times. Information was not always in place to guide staff on what care they needed to provide to meet some people’s specific needs.

The systems in place to monitor the quality of service being provided were effective. Audits had been conducted that had identified improvements that were required to the service and these were being worked on.

The staff were happy working for the provider and felt supported in their role. The provider had promoted an open culture where both staff and people using the service could raise concerns without any hesitation. People knew how to complain and any complaints were investigated and responded to.

We found that improvements had been made to the plans of care held in the office and a person's home and that they now contained the same information. We saw that they contained the information staff members needed to ensure that the health and safety of people was promoted.

People using the service told us that they had received the care and support they needed and that staff were excellent.

We saw that the people's individual medication was available and monitored and found that it was administered and recorded accurately and safely.

People using the service told us that staff members were kind and respectful towards them. They said that sometimes the time of their visit could change and that staff were occasionally in a hurry and under stress due to the number of additional people that they had to visit. We saw that additional staff members were in the process of being employed.

People using the service and their relatives told us their complaints were listened to and resolved. We found that there was a complaints system in place that met the needs of people using the service.