Archived: Mayfair Homecare Westminster

Updated 4 April 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.

Why we inspected. This was a routine inspection which we carried out as the provider had been rated ‘Requires Improvement’ 12 months ago. Since our previous focussed inspection in July 2017 we were aware of four allegations of possible abuse, including neglect. One of these concerned an incident where a care worker missed a number of calls due to a miscommunication about their working days. Two of these concerned emotional abuse by care workers which were investigated but not substantiated. One concerned an allegation of financial abuse, which was also not substantiated. We were also aware of an allegation regarding the management of a person’s medicines and poor continuity of staff. We found that this was not pursued as a safeguarding matter but the provider had investigated and addressed this.

Prior to carrying out the inspection we reviewed information we held about the service, including significant events the provider is required to tell us about. The provider completed a provider information return (PIR). This is a document where providers give information about their service, including what is going well and their plans to improve the service in future. We also contacted contracts and monitoring officers from the local authority to get their opinion on the quality of the service.

This inspection was carried out on 28 February, 1 and 7 March 2018 and was announced. We postponed the third day of the inspection from 2 March due to severe weather conditions. We gave the service 48 hour’s notice of the inspection visit because staff were often out of the office or providing care. We needed to be sure that they were in.

The inspection visit was carried out by an adult social care inspector who was accompanied on the final day by a pharmacy inspector. On the 28 February an expert by experience made calls to people using the service, and contacted seven people using the service, two relatives and a health and social care professional working with a person using the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. We spoke with the area manager, registered manager, care services director, team leader, co-ordinator, administrator and four care workers. We also spoke with a social worker involved in the care planning of a person using the service.

We reviewed records of care and support and electronic call monitoring relating to eight people using the service and records of medicines management for 11 people. We looked at records of recruitment and supervision for five care workers and records of training for all staff. We reviewed records relating to safeguarding, complaints and incidents and records relating to the management of the service, such as audits, satisfaction surveys and the rotas for 10 care workers.

Updated 4 April 2018

We carried out this comprehensive inspection of Mayfair Homecare-Westminster on 28 February, 1 and 7 March 2018. At our previous comprehensive inspection in January 2017 we found a breach of regulations regarding safe care and treatment and rated the service ‘Requires improvement’. We undertook a focussed inspection in July 2017 where we found the provider had successfully addressed this breach, but found a further breach regarding the management of medicines.

At this inspection we found that the service was now meeting regulations and we have changed their rating to ‘Good’.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides care and rehabilitation services to older adults and support to people with mental health needs in the London Borough of Camden and the City of Westminster. At the time of our inspection the service was providing personal care to 83 people. Not everyone using Mayfair Homecare-Westminster receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had a registered manager, who had been in post since November 2017 and completed their registration in February 2018. 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 told us they were treated with kindness and respect by staff. People’s views were sought through reviews and telephone monitoring. Accurate assessments of people’s needs were carried out yearly and care plans were designed to meet these needs. Care plans were concise and contained accurate and important details about the care people required and wanted. Care workers demonstrated they had delivered care as planned through accurate recording. People had consented to their care in line with the Mental Capacity Act 2005 (MCA).

Suitable recruitment systems were operated by managers to make sure that staff were suitable for their roles. There were good systems in place to make sure care workers arrived on time and that people were protected from the risk of missed or late calls. Care workers received the correct training and supervision to carry out their roles. Managers undertook spot checks and care worker assessments to make sure that care and support were delivered effectively and in a caring manner. This included carrying out additional checks where there were concerns about staff performance.

We had previous concerns about how medicines were managed, but at this inspection we found people’s support with medicines was correctly planned and managed by care workers. Regular checks were carried out by managers to make sure that this was carried out safely. We identified two areas where the provider could further improve medicines management in line with best practice guidance and have made a recommendation about this.

Care plans detailed the support people needed to eat and drink and people’s dietary preferences. There was evidence people received varied diets. People knew how to complain and when this happened complaints were appropriately investigated and responded to, although the provider did not always record whether people were satisfied with the outcome.

Managers had carried out a comprehensive audit of the service, including of people’s care files and the recruitment and oversight of staff. Care workers told us they felt well supported by managers. There were systems in place to monitor staff training, background checks of care workers and people’s reviews. Where audits identified issues these had been correctly addressed. This had resulted in clear improvements in the management and operation of the service.