Mosaic 1898 LTD

Updated 21 December 2019

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

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

The service had a manager registered with the Care Quality Commission. 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.

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.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and one relative of a person who used the service about their experience of the care provided. We spoke with the registered manager and the chief executive officer.

We reviewed a range of records. This included three people’s care records and one person’s medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We spoke with three care staff.

Updated 21 December 2019

About the service

Mosaic: Shaping Disability Services provides personal care and support for people in their own homes. At the time of our inspection 10 people were receiving personal care and support from the service.

Not everyone who use this type of service receive 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.

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

The provider did not always complete robust recruitment checks to ensure they employed people who were suitable to work with people who used services. They did not have robust systems in place to record incidents that occurred at the service.

The provider did not maintain records of their assessments of people's needs before the joined the service. People's records did not show the provider had considered the Mental Capacity Act as part of care planning.

The provider had not acted to address the issues identified at our previous inspection. The registered manager did not always demonstrate a good understanding of their regulatory responsibilities such as maintaining robust records of the care people received.

Records of people's risks assessment were not comprehensive. They did not always include information of known risks to people and guidance on how staff would minimise the occurrence of risks.

We made recommendations about risks assessments and end of life care planning.

People felt safe when they received care from staff. The service had protocols in place to protect people from the risk of contamination and infections.

Staff supported people to meet their nutritional needs and stay well. They supported people to access health care services.

Staff were kind and compassionate. They had developed positive relationships with people who used the service and treated them like they mattered. People were treated with great dignity and respect.

The support people received was tailored to their individual needs. Support was holistic and supported their general wellbeing.

The registered manager promoted an enabling culture which supported people to live a full life as possible and achieve their desired outcomes. Staff felt supported in their role.

The registered manager and staff team worked collaboratively with other professionals involved in people’s care to ensure that any transitions were well managed, and the care people received was consistent.

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; the policies and systems in the service did not always support staff practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service promoted choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to become more independent where possible.

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 Good, (published 15 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.