Cera - Essex and Havering

People’s experience of using this service:

Feedback from people we spoke with regarding the service was generally positive with one notable exception, the quality and consistency of communication between themselves and the management team. This impacted on the quality of the service people received. The mixed feedback we received also showed there were marked variations in the experiences of people using the service which demonstrated inconsistencies in how systems and processes were applied in practice. The failings we found had been identified by the provider but the improvements required had not always been sustained or consistently applied.

Whilst people were not always positive about the management of the service, people were positive about the care and support they received on a day to day basis and spoke highly of staff.

A very good feature of the service was the fact that people were supported by regular care staff. This meant people benefitted by being cared for by staff who knew them well and with whom they had developed a good rapport. This continuity of care was highly valued by people.

People felt safe using the service and staff knew how to keep people safe from the risk of harm. Risks to people had been assessed, however these sometimes lacked detail and were not always tailored to reflect people’s individual needs.

We made a recommendation about risk assessment and management.

Medicines were safely managed. There were sufficient staff deployed to safely meet people’s needs who had been safely recruited. Good infection control practices were used by staff to prevent the spread of infection.

Staff received training, supervision and appraisals to help them develop the necessary knowledge and skills to be competent in their role. Staff understood how to help people make decisions so that people had choice and control over their lives.

Where required, the service helped people to have enough to eat and drink and monitored people at risk of malnutrition or dehydration. Some people expressed dissatisfaction with the skills of some staff with regard to food preparation.

We made a recommendation about matching staff to people to ensure people’s needs and preferences were consistently met.

Staff were kind and caring and regularly went the extra mile. People were treated respectfully and with dignity and their privacy was respected.

The timing of care visits was not consistently person-centred as they did not always respect people’s routines and preferences. However, care staff took a person-centred approach in their daily practice when providing support by listening to people and providing care the way they wanted.

People were provided with information on how to make a complaint and systems were in place to respond appropriately. The views of people were sought to drive improvements, however feedback showed that improvements were not always sustained.

Staff were included in the running of the service. Staff told us the management team were supportive and they enjoyed working at the service.

Rating at last inspection:

Good (report published May 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The overall rating is Good.

Follow up:

We will continue to monitor the service through the information we receive.

Mears Care – New Futures is a domiciliary care agency (DCA) registered to provide personal care to people with learning disabilities living in their own homes. The level of support and care varied from a few hours each week to 24 hours seven days a week. At the time of our inspection 34 people were using the service.

The service had a registered manager. 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 registered manager was supported by a deputy manager to ensure the daily management of the service.

People were positive about the service and felt safe. Staff knew how to keep people safe and protect them from harm and abuse. Risks to people were well managed to ensure people were safe both within their own home and the local community. The registered provider had effective recruitment processes in place which ensured people were protected from the risk of avoidable harm. Accidents and incidents were recorded and monitored to identify and mitigate reoccurrence. Medication was dispensed by staff who had received training to do so.

Staff demonstrated that they knew people well. They had received regular training and supervision and were knowledgeable about their roles and responsibilities. Care plans were person centred and included people's preferences and routines. Care plans were regularly reviewed and people, and the people that mattered to them, were involved in the planning of their care. People were supported to access health and social care professionals and services when required.

People’s capacity to consent had been assessed and people had consented to their care and support. The registered manager demonstrated an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered provider acted in accordance with its legal responsibilities under MCA.

There was an effective quality assurance system in place to monitor the quality of the service and to help ensure the service was running effectively, meeting people’s individual needs and working towards continuous improvement.

The service had appropriate systems in place for the safe management of medicines. Care workers had been trained to administer medication and their competence had been checked.

People received their care and treatment from care workers who had been properly trained, supported and supervised. People experienced safe, quality care. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. People's complaints had been fully investigated and resolved where possible to their satisfaction.

People received safe, effective and compassionate care from a well led service that responds quickly to their changing needs.

People told us that they felt safe when using the service. We found that staff had been trained and had received regular updates in their training. Staff told us that they felt well supported. We found that supervision had not taken place on a regular basis. This meant that people may be at risk as staff were not fully supported to deliver care and treatment safely. The provider had a quality assurance system in place which had not always proved to be effective. The quality monitoring checks had not identified the shortfalls in staff supervision.