This comprehensive inspection took place on 13 September 2018 and was announced. We last inspected Millennium Employment Agency Limited on 29 January 2016 and found two breaches of legal requirements. These were in relation to safe medicines management, and staffing levels. We also made a recommendation in relation to the management of safeguarding concerns. At this inspection we found the provider had made improvements to the management of medicines and monitoring of staffing levels in relation to meeting people’s needs.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults and younger disabled adults. At the time of the inspection there were two people receiving personal care 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.
The provider did not have comprehensive auditing systems in place to manage the oversight of the service and drive improvements. Audits undertaken did not always identify issues in a timely manner. We made a recommendation in relation to the management oversight and auditing processes of the service.
People’s medicines were not always managed in line with good practice. Medicine administration recording sheets did not always contain adequate information to ensure the safe administration of medicines. We shared our concerns with the registered manager who submitted updated medicines administration records. We were satisfied with the provider’s response and will review this at their next inspection.
People received care and support from adequate numbers of staff deployed to meet their needs. People’s dependency needs were assessed regularly and staffing levels adjusted accordingly. Staff underwent robust pre-employment checks prior to commencing their role.
Risk management plans did not always give staff clear guidance on how to safely manage behaviours that challenged the service. We raised our concerns with the registered manager who sent us updated risk assessments. We were satisfied with their response.
People were protected against the risk of abuse as staff knew how to identify, respond and escalate suspected abuse. Staff received on-going safeguarding training and felt confident in whistleblowing.
Infection control measures in place ensured people were protected against the risk of cross contamination. Staff continued to be provided with adequate amounts of personal protective equipment to carry out their role safely.
Staff and the manager were aware of their roles and responsibilities in line with the Mental Capacity Act 2005. People’s consent to care and treatment was sought prior to care being delivered. People confirmed their consent to care and treatment was sought prior to being delivered.
Staff received guidance and support from the registered manager and reflected on their working practices through regular supervisions. People continued to receive support and guidance from staff who received regular training to enhance their skills and knowledge.
People were treated with dignity and respect and had their human rights protected and encouraged. Staff were aware of the importance of maintaining people’s dignity and confidentiality.
People received personalised care and support from staff as care plans were person centred, reviewed regularly and devised with input from people.
People were aware of the provider’s policy in reporting concerns and complaints. Complaints were investigated and a positive outcome sought in a timely manner. Where possible people were encouraged to participate in activities that met their social needs and interests.
People spoke positively about the registered manager. Staff were aware of the provider’s values for the service and people confirmed the registered manager was approachable. Records confirmed the registered manager sought partnership working to drive improvements.