Manford Deluxe Care Limited

Updated 21 January 2023

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 1 inspector.

Service and service type

Manford Deluxe Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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.

We sought feedback from the local authority who work with the service. We reviewed the information we already held about the service. This included their registration report and notifications. A notification is information about important events, which the provider is required to tell us about by law. We used all of this information to plan our inspection.

We used information gathered as part of monitoring activity that took place on 27 September 2022 to help plan the inspection and inform our judgements.

During the inspection

We reviewed a range of records. This included 2 people's care records and risk assessments and 1 person medicines records. We looked at 2 staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including audits, staff training, satisfaction surveys, policies and procedures. We also spoke with the registered manager and field coordinator.

We continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection. After the inspection, we spoke with 2 support workers, and 1 person who used the service and 1 relative by telephone about their experience of the care provided.

Updated 21 January 2023

About the service

Manford Deluxe Care Limited is a domiciliary care agency providing personal care support to people living in their own homes. The service provides support to a wide section of the community, people living with dementia, older people, people with physical disability, learning disability or autism spectrum disorder, younger adults, mental health and sensory impairment. At the time of our inspection, there were 3 people receiving personal care from Manford Deluxe Care.

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

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.

Right Support: The provider did not ensure they had robust systems in place to manage medicines. We saw one person’s medicine, was being prescribed as PRN medicine, which are medicines to be given when required. Staff did not have written guidance in place to follow when medicines were prescribed to be given "when required" or with a choice of dose to ensure this was administered safely. This meant staff did not have the information to tell them when someone may need the medicine or how much to give.

Staff understood people and their individual needs well. Staff provided kind, caring, person-centred care and support. People were supported by appropriate numbers of staff on each shift to ensure people's safety and meet their needs.

Right Care: The provider had no pre-assessment form in place to ensure people's preferences with support and care were captured prior to supporting them. We asked the registered manager to provide us 2 peoples’ pre-assessment forms in capturing people’s preferences with personal care and risks in relation to their health conditions. The registered manager was unable to provide this. This meant people were at risk of receiving care from staff who did not fully understand their health conditions or preferences in how care was delivered.

Where a person lacked mental capacity, the provider had not taken steps to confirm whether a relative had the legal authority to make decisions for them. Records confirmed the provider had not seen the lasting power of attorney documentation.

We recommend that the provider follows best practice guidance with MCA procedures.

Staff understood how to protect people from poor care and abuse. Staff had received training on how to recognise and report abuse and they knew how to apply it. People's care, treatment and support plans reflected their range of needs and staff knew people's needs well.

The service had enough appropriately skilled staff to meet people's needs and keep them safe. Safe recruitment processes were followed.

People had the privacy they needed and were treated with dignity and respect. They were supported to be as independent as possible. Confidentiality of people's personal information was maintained. There was a complaints procedure which provided information on the action to take if someone wished to make a complaint and what they should expect to happen next.

Right Culture: The quality assurance and governance processes in place needed to be strengthened as they had not addressed issues we found with the quality of medicines, pre-admission form, and, confirming whether a relative had the legal authority to make decisions for a person. The registered manager showed they were open to learning and improving the service, though the provider needed to strengthen the systems in place to drive improvements. Staff were aware of their roles and responsibilities and felt supported by the management team.

There was a positive culture at the service and people benefited from being supported by happy staff which was reflected in the atmosphere at the service. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. Staff told us they enjoyed their job and making a positive difference to someone's life.

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

This service was registered with us on 05 January 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, good governance and person-centred care at this inspection.

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.