The Care Quality Commission
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Archived: Mears Homecare Limited Norfolk

Overall: Requires improvement read more about inspection ratings

Suite 1,6,7 Wensum Mount Business Centre, Low Road, Norwich, Norfolk, NR6 5AQ (01603) 309270

Provided and run by:
Mears Homecare Limited

All Inspections

14 January 2015

During a routine inspection

This inspection was announced and started on 14 January 2015.

At the last inspection on 16 and 17 June 2014 we asked the provider to take action to make improvements to the care and welfare provided to people, staffing levels, support and training for staff and effective systems that monitored the quality of the service. At this inspection we found the action required by the provider had been taken. However, on-going improvements were still in progress for recruiting staff.

This is a domiciliary care service providing care and support to approximately 270 people living in their own homes across the county of Norfolk. It did not have a registered manager at the time of this inspection. However, a manager had recently been recruited and informed us they had started the process of being registered. 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 receiving a service from Care UK told us that they were supported safely by staff who were kind and courteous. Potential risks were assessed and action was taken to minimise or reduce the risks.

Staff were aware of potential abuse, knew the signs to look for and would act appropriately if they had any concerns abuse may be happening.

The service had a robust out of hour’s system to cover any emergencies that may occur. Staff were fully aware of the system and had access to a duty officer whenever required.

The service had a shortfall in the number of care staff required and another care agency was covering the shortfall. However, the manager was in the process of recruiting to ensure enough staff were employed in the future to deliver the service required.

People who required support with taking their medicines were assisted by staff who were competent and trained in the administration of medicines.

People were supported by staff who had the skills to support them properly. Staff received induction and training to enable them to carry out their roles effectively. Staff had a clear understanding of the Mental Capacity Act and knew what to do if they felt a person was being deprived of their liberty. The majority of staff held a recognised qualification in care.

The service had improved the support to staff by providing more localised and accessible access to office facilities and senior staff contact.

Meals prepared by staff were offered with choice and people were supported to eat and drink sufficient amounts.

Staff had access to health care professionals with all phone numbers recorded on individual care plans to use as and when required.

The staff who supported people regularly were praised highly by the people using the service and their relatives. Where there was inconsistency of staff people were not benefitting from consistency in care support provided.

The majority of staff were supporting people appropriately and effectively by offering the individual care required to promote good health and offer reassurance when people were a bit apprehensive. The minority of staff provided were not always effective and improvements in staff recruitment were required.

Some improvements recently made were evident at this inspection. New methods had been introduced to monitor the quality of the service provided. The manager was at the centre of all the activity taking place and was aware of any concerns or complaints. They ensured that improvements were being made and that timely action taken.

The improvements recently introduced, the sharing of information and the openness within the whole staff team had improved the working relationships within the service.

16, 17 June 2014

During a routine inspection

An inspector from the adult social care directorate of the Care Quality Commission carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

The majority of people told us they felt well looked after and safe. They said this was mainly due to consistency of staff who knew the people they were supporting well. Words such as, 'Brilliant', 'Kind', 'Understanding' and 'Ideal', were just some of the positive descriptions of staff. However, some areas of Norfolk, where the provision of staff was inconsistent, people told us they felt vulnerable and unsafe. 'New staff keep coming and they don't know what I need so I keep repeating myself.' Another person said, 'I have too many different carers.' A relative said they were looking for another agency as Care UK was not supporting their family member in a safe and suitable manner.

Staff were recruited safely with appropriate checks completed before they commenced work. Induction of new staff ensured they had the correct skills to do the job required.

Staff were not up to date with training so we could not be certain they were working safely and appropriately. Limited supervisions had taken place to check their working practices.

We have asked the provider to tell us how they will make improvements to ensure people are safely supported and meet the requirements of the law.

Is the service effective?

The service did carry out reviews of people's care needs yet action that was identified as requiring changes was not always carried through by staff.

Medication administration was audited but the action taken in response to errors found was not evident. Therefore we could not be assured that effective action had been taken to address shortfalls or that medication had been administered correctly to people following the errors found.

Staff training had been identified as overdue but action had not been taken to address shortfalls.

We have asked the provider to tell us how improvements will be made to ensure the service is effective and meet the requirements of the law.

Is the service caring?

The majority of responses we were given by people using the service and those we read in the quality assurance questionnaires were positive about the quality of care provided. However some comments that were less positive told us the service was not caring. We could not find evidence to show how the provider had address these concerns.

We were told that sometimes, the people receiving the service did not get a call at all or the call could be very late. Those people told us they felt anxious and worried the care would not be provided.

We have asked the provider to tell us how improvements will be made to ensure the service is offering a caring service to all people they provide care and support to and that they meet the requirements of the law.

Is the service responsive?

The service did have a complaints procedure. People we spoke with who were unhappy with the service felt they had been listened to but their complaints had not been acted upon. 'I have told them twice I need to stick to my care plan timings but the rotas still show the incorrect time.' A second person said, 'I am going to look for another care provider as I cannot cope with irregular times, irregular staff and nothing being done about it.' Another person said, 'I have been visited by management but nothing has changed.'

Concerns that people had raised in questionnaires sent out to them to ask their views on the quality of the care provided had not been acted upon. A number of those we read required action to be taken in February 2014. By the time of this inspection in June nothing had been done.

We have asked the provider to tell us what improvement will be made to show that people are listened to when complaints or concerns are raised and that they meet the requirements of the law.

Is the service well led?

This service had recently recruited a new manager who was yet to register as the manager with the Care Quality Commission. The service had one office to support over 500 people around Norfolk. The new manager had recognised the need for structural changes within management and supervisory staff to meet the demands of the service and the wide geographical area covered by this domiciliary care service. However, the changes for this service had not been fully implemented by this inspection.

The new manager had experience and skills that should ensure the service was well led. Areas for improvement were discussed with the manager but many were yet to be implemented.

The service was working with the local authority to action improvements but progress was slow.

We have asked the provider to tell us what improvements will show that the action required has been carried out timely and thoroughly to meet the shortfalls identified.