Mercylink Care Cambridgeshire

Updated 10 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by an inspector and an Expert 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 23 August 2022 and ended on 20 September 2022 when we visited the location’s office.

What we did before the inspection

We used information gathered as part of monitoring activity that took place on 23 March 2022 to help plan the inspection and inform our judgements.

We reviewed information we had received about the service since they registered with the CQC. We sought feedback from two local authorities who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We used technology such as telephone calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review some of the documentation requested. We spoke with five people who used the service and three relatives of people who used the service about their experience of the care provided. We received feedback from two local authorities. We spoke with five members of staff including the registered manager, and four care staff.

We reviewed a range of records using electronic file sharing and during our site visit. This included four people's care records and medication records. We looked at three staff files in relation to recruitment, and right to work permits during our office visit. We also looked at staffs training and staff supervision. A variety of records relating to the management of the service were also reviewed, including training records, incident records, compliments, quality assurance processes and policies.

After the inspection

We continued to seek clarity about whether the service provided the regulated activity of personal care support to people with a learning disability and or autism. The registered manager told us they did not at the time of this inspection.

Updated 10 November 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Mercylink Care Cambridgeshire is a domiciliary care service that provides personal care and support to people living in their own homes. They also provide live-in care support. This means a staff member lives with the person in their own home. The service provided personal care and support to 37 adults at the time of the inspection.

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

People, and their relatives had mixed opinions as to whether they were asked to formally feedback on the quality of the service provided. Staff completed a survey which in the main was positive, however it was unclear how feedback from staff was used to improve the service. Audits were carried out to monitor the quality of the service provided. These audits were not always robust enough to identify all areas needing improvement. The registered manager’s oversight of audits and their findings were not always clear or detailed enough to identify patterns and trends on an ongoing basis.

People’s needs were assessed before they started using the service to ensure their needs could be met in line with current guidance and legislation. Staff were trained, however people had mixed opinions about how competent some new staff were when supporting them. Staff had some spot checks undertaken to check their competency. However, catheter care spot checks had not been completed recently to ensure staff followed this training. Staff were encouraged to discuss and review their performance through supervision and team meetings.

Potential new staff to the service had a series of checks carried out to ensure they were suitable to work with the people they supported. Staff were kind and respectful towards people. Where people or their relatives had raised concerns, these were investigated. There were enough knowledgeable and trained staff to meet people's care and support needs. Staff understood how to keep people safe from poor care and harm. Staff told us they would whistle-blow any concerns they may have to their registered manager or the CQC. Where people wanted to discuss their end of life wishes this information would be recorded to guide staff.

Staff had access to information in peoples' care plans and risk assessments that helped guide them to care and support people effectively. However, risk assessments for catheter care support and or hoisting could be more detailed to help guide staff. Staff told us they were trained in infection prevention and control and followed good practice guidance in relation to this. Systems were in place to learn lessons when an incident, accident or near miss occurred or there was a risk of this.

Staff encouraged people to drink and eat plenty. People were encouraged to make their own choices and these choices were respected. Staff helped promote and maintain people's privacy and dignity. Staff also encouraged people to be as independent as possible and with the support from staff people were able to remain in their own homes. Staff also encouraged people and their relatives, where appropriate, to be involved in discussions around their support and care needs.

The registered manager worked with external health and social care professionals. This would help people to receive joined up care and support. There was a process in place to investigate and resolve complaints wherever possible. The registered manager took actions as a result of learning to try to reduce the risk of recurrence.

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.

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

Rating at last inspection

This service was registered with us on 30 June 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This inspection also was based on the service being unrated since it registered with the CQC.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to Regulation 17(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Whilst there was no evidence of risk of harm to people, quality monitoring systems were not robust enough to accurately monitor and identify areas found requiring improvement. 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 work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.