Archived: County Medicare

Updated 13 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an announced inspection. We told the deputy manager before our visit that we would be coming. We did this because they were sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure they would be in. The inspection was undertaken by an inspector and 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.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people, we looked at any notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During our inspection we went to the office on 21 November 2017 and spoke with the deputy manager and six staff members. We reviewed the care records of four people that used the service. We looked at staff recruitment files, supervision and training records, and spoke with the deputy manager about the systems in place for monitoring the quality of care people received. We looked at medicine records, complaint records, accidents and incidents and policies and procedures

Before the inspection visit we undertook phone calls to six people and relatives of five people who used the service to get their feedback about what it was like to receive care from the staff. After the inspection we contacted three health and social care professionals to get their views on the service.

Updated 13 January 2018

We undertook an announced inspection of County Medicare a Domiciliary Care Agency (DCA) on 13 and 21 November 2017. We told the deputy manager before our visit that we would be coming. We did this because they were sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure they would be in. The inspection involved a visit to the agency’s office and telephone conversations with people who used the service and healthcare professionals.

At our previous inspection in November 2016 we asked the provider to make improvements in relation to people’s risk assessments and records. We found these improvements had been made.

County Medicare is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and younger adults, people with a physical disability or sensory impairment. It also provides support to people living with dementia. People received support related to personal hygiene, mobility, nutrition and continence. Some people were living with early stages of a dementia type illness or other long-term health related condition. Most people lived reasonably independent lives but required support to maintain this independence. County Medicare also provided support for people who required end of life care. At the time of our inspection no-one was receiving end of life care.

There is a registered manager 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 2008 and associated Regulations about how the service is run. At the time of the inspection the registered manager was temporarily not working at the service. In their absence the deputy manager was responsible for the day to day running of the service.

People received care that was responsive and had been tailored to ensure it was individual to each person. People and family members spoke highly of the kind and caring nature of the staff. They told us the care they received was person-centred and met their individual needs and preferences. Family members told us their needs were also taken into account when care was provided. People were involved in the planning of their care and supported to make their own choices. Care plans explained how to support people and provided clear guidance. Care plans were person-centred and reviewed with people to ensure they reflected their current needs. Staff understood the importance of providing good person-centred care.

Staff had developed positive relationships with people. They had time to spend with people to ensure all their needs were met. Staff treated people with kindness, compassion and respect. The care they provided helped people to maintain their dignity.

Risk assessments and guidance was in place and staff had a good understanding of the risks associated with the people they looked after. Medicines were well managed and staff ensured people received the medicines they had been prescribed.

There were enough staff working, who had been appropriately recruited, to meet people's needs. Staff received the induction, training and support they needed to enable them to meet people’s needs. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and ensured people’s legal and human rights were protected. Staff understood the procedures in place to safeguard people from the risk of abuse or discrimination.

People were supported to eat and drink a variety of food that met their individual needs and preferences. People’s health and well-being needs were met. People were supported to have access to healthcare services when they needed them.

People were regularly asked for their feedback, they were listened to and their comments acted on. There was an effective process for managing complaints which people told us they would feel confident to use

The deputy manager promoted an inclusive and open culture and recognised the importance of effective communication.

There were systems in place to assure quality and identify any potential improvements to the service being provided.