Margaret House

Updated 9 August 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

One inspector and an Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service 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.

Inspection activity started on 11 July 2023 and ended on 19 July 2023. We visited the location’s office/service on 11 and 13 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who use the service and 5 relatives about their experience and support they received. We spoke with 6 members of staff, this included the nominated individual, the registered manager and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 4 people’s care plans and medicines records. We reviewed 3 staff files and a variety of records regarding the management of the service.

Updated 9 August 2023

About the service

Margaret House is a domiciliary care agency providing personal care. The service provides support to older people and people who may be living with dementia. At the time of our inspection there were 25 people using the service who received a regulated activity. 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 provide a regulated activity, we also consider any wider social care provided.

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

Governance systems in place had not been effective at identifying areas for improvement. Records were not always in place or did not contain sufficient detail. Medicines management was not always in line with best practice. We have made a recommendation about this.

Staff knew people well and knew their individual needs and risks. However, risk assessments were not always in place or were not always sufficiently robust. Accident and incident forms were completed, but the reviews of these had not always been completed. Staff had sufficient PPE and understood their responsibilities in relation to managing the risk of spread of infection.

Staff received an induction and training. However, not all staff had been enrolled on the care certificate as part of their induction. Staff told us they felt well supported in their roles. Pre assessments were completed prior to people receiving their support. People were supported to have maximum choice and control of their lives and staff supported hem in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by kind and caring staff, who they had developed positive relationships with. Staff respected people’s privacy and dignity.

People received person centred care in line with their wishes and preferences. However, further information was needed in their individual care plans. People's end of life wishes had been recorded and the provider was developing their end of life care plans.

Satisfaction surveys had been carried out to gather people views, these had been summarised, but no action plan developed. Staff felt well supported by the management team and felt it was a good company to work for. People felt confident to approach the management should they have any concerns.

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

Rating at last inspection

This service was registered with us on 08 April 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 governance at this inspection. Please see the action we have told the provider to take at the end of this report. We have also made a recommendation regarding medicines management.

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.