Cera - Lancashire

Updated 13 December 2018

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 30 October, 01, 02 and 08 November 2018. We gave the service 24 hours’ notice of the inspection visit because we needed to be sure that they would be in.

The inspection team consisted of one adult social care inspector, one assistant inspector and two experts 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. The experts by experience had experience of caring for older people who received support within a community setting.

Before our inspection, we checked the information we held about Mears Care Lancashire. This included notifications the registered provider sent us about incidents that affect the health, safety and welfare of people who received support. We also contacted the commissioning, safeguarding and contracts departments at Lancashire County Council. This helped us to gain a balanced overview of what people experienced when they received support from Mears Care Lancashire.

We looked at information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. All the information gathered before our inspection went into completing a planning document that guides the inspection. The planning document allows key lines of enquiry to be investigated focusing on any current concerns, areas of risk and good or outstanding practice.

During this inspection, we visited eight people in their own homes in the Wyre and Rossendale areas. One adult social care inspector visited the office and met with the management team. They also made three prearranged visits to people living in the Wyre area. An assistant inspector made five prearranged visits to people living in the Rossendale area. Two experts by experience telephoned 10 randomly selected people and four relatives in the Wyre and Rossendale area for their views on the service. The inspector spoke by telephone with four randomly selected staff for their views on the service. The registered provider did not select and was unaware who the inspection team contacted by telephone. We also attended a charity cake and coffee morning held at the office and spoke with four people who received support and one person’s friend.

We spoke with the registered manager, deputy manager, five members of the management team and seven carers who visited the office during the inspection. We contacted one community health professional for their experience of the service provided by Mears Care Lancashire. We looked at the care records of 18 people, training and recruitment records of 10 staff members, records relating to the administration of medicines and the management of the service.

We looked at what quality audit tools and data management systems the provider had. We reviewed past and present staff rotas, focusing on how staff provided care within a geographical area. We looked at how many visits a staff member had completed per day and if the registered provider ensured staff had enough time to travel between visits. We looked at the continuity of support people received and how long staff stayed on each visit by reviewing the registered providers electronic call monitoring system.

We used all the information gathered to inform our judgements about the fundamental standards of quality and safety of the service delivered by Mears Care Lancashire.

Updated 13 December 2018

Mears Care Lancashire was inspected on the 30 October, 01,02 and 08 November 2018 and the inspection was announced. The registered provider was given 24 hours' notice as we needed to be sure people in the office and people the service supported would be available to speak to us and all subsequent visits we prearranged.

Mears Care Lancashire is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the Rossendale and Wyre areas. It is registered to provide a service to older adults, people who have a physical disability and people living with mental ill health. The location provides ongoing at home care and crisis care. Crises care is a short term, three day service to help people who require immediate support. This meant client numbers went up and down during out inspection. At the time of our inspection, the service was providing support to approximately 280 people.

Mears Care Lancashire 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.

This was the locations first inspection since it had changed its legal entity. Under the previous legal entity, the location was inspected and rated Good.

During this inspection, we found staff had received training to safeguard people from abuse. They understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of adults who may be vulnerable. Staff we spoke with told us they were aware of the safeguarding procedure.

Care plans were completed with the support of people and their families and identified all assessed risks. We found they were personalised and informative and had been kept under review and updated when necessary. They reflected any risks and people's changing needs.

There was an appropriate skill mix of staff to ensure the needs of people who used the service were met. New staff were mentored by experienced staff members whilst they learnt their role. Staff members received training related to their role and were knowledgeable about their responsibilities.

They had the skills, knowledge and experience required to support people with their care and support needs. The training included the administration of medicines and Dignity and Respect. We found staff understood the Mental Capacity Act 2005 (MCA). One person said, “The staff are on the ball.”

The registered provider planned visits to allow carers enough time to reach people and complete all tasks required. People told us they mostly had the same staff visit and relationships had developed. One person told us, “The staff are very well liked, they bring their manners with them. They are really very nice.” A second person commented, “ My mood is always lifted when they have been.”

The registered provider completed spot checks on staff to observe their work practices were appropriate and people were safe. Staff were provided with personal protective equipment to protect people and themselves from the spread of infection.

The registered provider had procedures around recruitment and selection to minimise the risk of unsuitable employees working with people who may be vulnerable. Required checks had been completed before any staff started work at the service. This was confirmed during discussions with staff.

When appropriate, meals and drinks were prepared for people. This ensured people received adequate nutrition and hydration.

People and their families were supported by trained staff during their end of life care.

Care records contained information about the individual's ongoing care and rehabilitation requirements. This showed us the registered provider worked with other health care services to meet people's health needs.

A complaints procedure was available and people we spoke with said they knew how to complain. At the time of our inspection, the registered provider had received no formal complaints. One person commented, “No complaints, all the staff are little belters.”

The registered manager had sought feedback from people receiving support and staff for input on how the service could continually improve. The service demonstrated good management and leadership with clear lines of responsibility and accountability within the management team.

The registered provider had regularly completed a range of audits to maintain people's safety and welfare and showed lessons learnt and action taken.

Staff told us they received regular formal and informal support from the management team and the management team were supportive and available.