Forget Me Not Care Limited

Forget Me Not Care Limited is a domiciliary care agency providing personal care to people in their own home. At the time of our inspection there were 37 people receiving personal care from the service.

Not everyone who used the service received personal care. The Care Quality Commission (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

Following the last inspection, the provider had taken action to address the breaches of regulation and improve the service.

People felt safe receiving care from staff. The provider had taken action to keep people safe and manage the risks they faced. Systems to protect people from the risk of financial abuse had been improved.

People were supported to take medicines safely and staff sought advice from health and social care services when necessary. Staff kept good records of the medicines support they provided to people.

Staff had a good understanding of the support people needed. Staff supported people to do as much for themselves as possible and maintain their independence.

The provider completed a criminal record check and obtained references from previous employers of new staff before they started work. People said staff had the skills and knowledge to meet their needs.

The provider had established good systems to monitor the quality of service provided and make improvements where needed. The registered manager worked with people, staff and other professionals to ensure people achieved good outcomes.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 August 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out a comprehensive inspection of this service on 14 June 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding people form abuse and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Forget Me Not Care Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone who used the service received 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

Not all risks to people’s safety had been identified. One person for example, had thickener in their drinks to minimise the risk of aspiration but the amount or required consistency was not stated in their records. Staff left another person’s medicines out for them to take later yet this had not been assessed as safe.

Following the last inspection, some action had been taken to ensure the safe management of people’s medicines. However, at this inspection, some shortfalls remained. There had been errors and records did not show the instructions for the use of topical creams. Staff had administered one person’s laxative without clear instructions of its prescription.

The shortfalls regarding medicines and risk management, had not been identified. The registered manager told us they had requested assistance from the local authority to improve the auditing systems in place. This work was being undertaken.

Systems in place were not sufficient to safeguard people from financial abuse. This was because staff accessed some people’s money, without there being clear control measures in place. The assistance people needed in this area was not detailed in their support plan. Following the first day of the inspection, this was being addressed.

There was a caring ethos that was adopted throughout the staff team. People were happy with their support and received a service that was responsive to their needs. Any changes, or additional support was arranged in a timely manner.

There were enough staff to support people. More staff were being recruited to accommodate new people to the service.

People were supported by a small team of staff who knew them well. Staff arrived on time and there were no concerns about missed calls.

People were fully assessed before being offered a service. Their needs and preferences were detailed within a support plan, which they helped to devise and review.

There was a focus on community engagement. People were assisted to attend community groups or go to the library or the local sports centre, if desired.

People were complimentary about the staff and their rights to privacy, dignity and independence were promoted.

Staff felt well supported and received a range of training to help them do their job more effectively.

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 supported this practice.

The registered manager worked three days a week and was available as required. Another manager worked the other days, which ensured management cover.

Rating at last inspection - The last rating for this service was Good. (The report was published on 6 January 2017). At this inspection, the rating dropped to Requires Improvement.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up: We will monitor all intelligence about the service and complete another inspection in line with this and our frequency of inspection guidance.

This inspection took place on 16 November 2016. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a home care service. We wanted to make sure the registered manager, or someone who could act on their behalf, would be available to support our inspection.

There was a registered manager in post at the service. 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.

Systems to support people with their medicines were not always clear and it was not always recorded what action had been taken if people had not taken their medication as it had been prescribed. It was not clear that the on-call manager had sought medical advice about the action to take following errors. The registered manager said medical advice had been sought, but this had not been recorded. As a result the registered manager had introduced new recording systems, which included details of who had been consulted and whether any further action was needed. Despite the lack of detail in plans, staff were able to consistently describe the support people needed with their medicines and how it was provided.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included, “They provide whatever care is needed. They are absolute gems”, “The carer has the right skills. She knows what she is doing and does it well” and “I feel extremely safe with staff in my home. They’re lovely”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Staff understood the needs of the people they were providing care for. Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service and demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs. Comments from staff included, “We don’t go out to people without knowing their needs” and “They make it clear that we need to be 100 per cent sure before going out to people”.

The service was responsive to people’s needs and wishes. People had regular meetings to provide feedback about their care and there was an effective complaints procedure. People and their relatives felt they could contact the office if needed and they also had contact numbers for out of office hours, in case of an emergency.

The provider regularly assessed and monitored the quality of the service provided. Feedback from people and their relatives was encouraged and was used to make improvements to the service.

We found the management of medicines to be safe and appropriate to people's needs. Staff were competent and well supported by the management team.

The quality of the service was being monitored and systems were in place to manage risks to people's health, welfare and safety.

People experienced care and support which was planned around their individual care needs. People told us they were involved in making decisions about their care. People told us that the service listened to them and they knew who to speak to if they had any concerns. People told us they liked the staff that came to their home and described having a good relationship with them. One person said 'They are extremely nice and give a good service.'

We were told that the staff were usually on time and good at their job. People told us they would be phoned with an explanation if staff were ever delayed. These views were supported by the results of the annual service user satisfaction survey we saw, which said staff arrive on time or sometimes can be early.

Staff received training and guidance which helped to ensure they supported people safely. When people told us about the staff team their comments included "always been very happy with the service" and "they do a good job.' Staff said they felt supported by the managers and were regularly informed about any changes to the service.

The records held by the service in their offices and people's own home were kept up to date. This helped and supported staff to give people using the service safe, personalised care.