MMR Homecare South London

Updated 16 March 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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the London borough of Lambeth.

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

This inspection was announced. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before 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 2 people who used the service and 10 relatives to gather their views. We spoke with 9 staff members including care workers, the registered manager and the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed 7 care plans, records and other records relating to the management of the service. After the inspection the registered manager sent us an action plan, policies and procedures and the medicines administration records.

Updated 16 March 2023

About the service

MMR Homecare South London is a domiciliary care agency providing personal care to older people in their own homes and flats. At the time of our inspection there were 148 people using the service.

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

People’s medicines were not always managed safely and in line with good practice. People did not always receive support from a service that managed safeguarding alerts appropriately. Potential risks to people were not as safely managed as they could be to ensure the likelihood of risk occurrence was mitigated. People were at risk of receiving care and support from unsuitable staff as the registered manager did not have an embedded and robust recruitment process in place. People did not receive care and support from a service that learned lessons when things went wrong.

People were supported by a service that did not have adequate understanding of the duty of candour. Records were not easily accessible. Although people’s views were sought, the service failed to effectively document these. After the inspection we spoke with the Nominated Individual who acknowledged the issues identified at this inspection and immediately submitted an action plan to address the shortcomings. We will monitor their stated aims at the next inspection.

People received support from staff that did not always have their competency assessed. People did not always receive care and support from staff that treated them with kindness and respect.

People received support to access sufficient food and drink that met their dietary needs and preferences. People were supported to access healthcare services, were supported to maintain their independence and were treated with dignity. People’s care and support was personalised to their individual needs and preferences. People received a service that was swift in responding to and investigating complaints to seek a positive outcome for those involved.

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.

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 19 July 2022 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and safeguarding management. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines management and oversight and monitoring of the service 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.