Royal Mencap Society - Central Hampshire

Mencap East Hampshire is a domiciliary care agency and is registered to provide personal care to people in their own homes, some of whom lived in a ‘supported living’ environment. It provides a service to adults who have a learning disability or autistic spectrum disorder and younger adults. Not everyone using Mencap East Hampshire Domiciliary Care Agency received a 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. At the time of the inspection they were providing personal care to six people across Hampshire.

What life is like for people using this service:

People did not always receive a service that provided them with safe, effective and high-quality

care. risk management was not always effective. This meant that people could be at risk of harm.

The management of medicines had improved since the last inspection; however, further improvements were required.

Not all care plans covered a full range of people’s needs and some lacked guidance for staff.

Staff received regular support and supervision however, the provider was unable to demonstrate that staff’s concerns had been responded to and acted upon. Staff told us they felt well supported by the registered manager and had enough training to undertake their roles effectively.

Quality assurance processes were in place but needed some further development to ensure they were always effective in identifying areas for improvement promptly, as well as identifying trends.

People told us that care workers were good and that they were happy with the service being provided. Staff knew what was important to people and ensured people had support that met their needs and choices. People’s dignity and privacy was respected, and their independence was promoted.

Rating at last inspection: Requires Improvement (report published 13 February 2018)

Why we inspected: This was a planned comprehensive inspection.

Follow up:

At the last inspection this service was rated ‘requires improvement’, at this inspection the rating remained the same. As the service is rated as requires improvement again we will meet with the provider following this report being published to discuss how they will make changes to ensure the service improves their rating to at least Good. We will request an action plan from the registered provider about how they plan to improve the rating to good and in addition, we will monitor all information received about the service to understand any risks that may arise and to ensure the next planned inspection is scheduled accordingly.

More information is in the detailed findings below.

This service is a domiciliary care agency and is registered to provide personal care to people in their own homes. It provides a service to adults who have a learning disability. Not everyone using Mencap East Hampshire Domiciliary Care Agency received a 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.

There were seven people receiving personal care at the time of the inspection.

A registered manager was in place. 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.

The registered manager oversaw the running of the full service and was supported by two service managers who were allocated a geographical area to manage. Service managers were responsible for individual parts of the service, for example support to people in a supported living home or support to people living in their own home. The service employed 19 care workers, 2 service managers and an assistant service manager.

Risks associated with the environment people lived in were not always managed well and medicines management was not always safe.

People told us they were always asked for their permission before personal care was provided, however their ability to make decisions was not always assessed in line with the Mental Capacity Act, 2005 (MCA). Staff’s understanding of the MCA was limited.

Some people knew how to complain, however complaints were not always dealt with according to the provider’s policy.

Although the management team had regular contact with the people using the service, there was no system in place to ensure feedback was acted on.

People’s records in relation to their care plans and medicines were not always accurate and up- to- date. Daily notes about individuals' care were maintained but these were not regularly overseen by the management team.

The quality assurance process was not robust so the service was not able to effectively monitor, review and adapt the service.

The provider had not always notified CQC of significant events that happened in the service.

People mostly felt safe and staff demonstrated an understanding of safe practice. Procedures for safeguarding people were in place.

Risk assessments identified risks for each person, although records were not always updated on a regular basis.

Recruitment procedures ensured staff were vetted and their suitability to work with vulnerable people was checked. Staffing levels were supportive of people's needs.

Staff had opportunities to update their skills and professional development and staff said the training they received was very good.

People told us kind and caring staff supported them and relatives said staff were professional in their approach.

Staff worked well together and felt supported by managers and the organisation.

We identified 4 breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

There were eight people in receipt of personal care support at the time of this inspection visit. People were supported with a range of needs that included; personal care, medicines administration and meal preparation.

The service 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. There were arrangements for managerial cover should the registered manager be absent.

The registered manager oversaw the running of the full service and was supported by three service managers who were allocated a geographical area to manage. Service managers were responsible for individual parts of the service, for example support to people in a supported living unit or support to people living in their own home.

The service employed 23 care workers, service managers and an assistant service manager.

This was the first inspection of this service since they were registered on 04 March 2014.

There were arrangements in place to protect people from risks to their safety and welfare. Staffing levels were sufficient to support people safely. Recruitment processes were in place to make sure only workers who were suitable to work in a care setting were employed. Arrangements were in place to support people with their medicines safely and to administer them according to people's needs and preferences.

Staff received appropriate training to make sure they had the skills and knowledge to support people to the required standard. New staff received a thorough induction to make certain they had the skills and knowledge to support people. Staff received regular supervision to make sure their competence was maintained and to ensure they were formally supported.

People found staff to be kind and caring. They were encouraged to take part in decisions about their care and support and their views were listened to. Staff respected people's individuality, privacy, dignity and independence.

The service involved people in the care assessment and planning processes. Care and support was based on individual assessments that took into account people's needs, conditions, and preferences. Staff were aware of people's support needs and preferences.

Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided.