Background to this inspection
Updated
25 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place between the 4 and 6 April 2018 and was announced. We gave the provider five days' notice to gain consent from people or relatives we wished to speak with. This because some of the people using the service could not consent to a home visit or phone call from an inspector, which meant that we had to arrange for a ‘best interests’ decision about this.
The inspection was undertaken by one inspector and an assistant inspector (observer) and three experts 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. Their area of expertise was for older people and people living with dementia.
Before the inspection the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least annually. This provides us with information about the service, what the service does well and improvements they plan to make. We used this information to assist us with the planning of this inspection. We also looked at other information we hold about the service. This included information from notifications the provider sent to us. A notification is information about important events which the provider is required to send to us by law such as incidents of harm or allegations of this. We also sent out survey questionnaires to people, relatives, healthcare professionals and staff. We used response to these questionnaires to help make a judgement about the quality of service people received.
Prior to our inspection we contacted organisations to ask them about their views of the service. These were, the local safeguarding authority, commissioners of the service and the local authority quality improvements team (QIT). These organisations’ views helped us to plan our inspection.
On the 4, 5 and 6 April 2018 we spoke with 16 people using the service who were able to give us their verbal views of the care and support they received. We spoke with 10 relatives of those people who were not able to speak with us where they lacked mental capacity.
We spoke with the registered manager, three office based staff who had management responsibilities and three care staff.
We looked at care documentation for four people using the service at Mears Care - Peterborough (Orton), medicines records, two staff files, staff training records and other records relating to the management of the service including audit and quality assurance records. We also looked at records of people's achievements and social outcomes.
Updated
25 April 2018
Mears Care - Peterborough (Orton) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It is registered to provide a service to older people, people living with dementia and people with mental health needs. Not everyone using Mears Care - Peterborough (Orton) received a regulated activity; Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
This inspection was carried out between 4 and 6 April 2018 and was an announced inspection. At our inspection in August 2015 the service was rated as 'Good'. At this inspection in April 2018 it remained Good'. At the time of our inspection there were 163 people 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.
People received a safe service. Staff kept people safe from harm, they knew how to report any concerns and actions were taken when incidents occurred. Checks were undertaken to help determine staff's suitability before they started caring for people. Only suitable staff whose good character had been established were offered employment at the service. There was a sufficient number of staff in post who had the skills and training they needed to provide people with safe care and support. People’s medicines were administered and managed safely.
People helped determine what their care arrangements were and the provider took account of people’s wishes and choices and any future goals. People’s care and support plans were an individual record about each person’s needs and any assistance they required from staff. Risks to people were identified, and plans were put into place to promote people’s safety without limiting people’s right to choose what they wanted to do. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People received a caring service. People were looked after and cared for by staff who showed compassion, respect and upheld their dignity. Staff undertook people's care in an unhurried and considerate manner. People's independence was promoted by staff who encouraged people to make their own decisions about their care. People were provided with information about advocacy services if they needed someone to speak up for them.
People received an effective service. Staff benefitted from the support, training and mentoring they were provided and this helped to promote people’s safety and wellbeing. Staff understood their roles and responsibilities in meeting people’s needs. System including regular spot checks and were in place to help staff to maintain their skills and the standard of work expected from them by the registered manager.
People were supported to maintain their health by staff who enabled or supported them to access community or other primary health care services. Staff assisted people to maintain the correct level of nutritional intake of food and fluids.
People received a Responsive service. This helped them to have their needs met in a person centred way. People were supported to maintain contact with their relatives and friends when they wished to do so. There was a process in place to manage any concerns, suggestions and complaints. Complaints were resolved to the complainant’s satisfaction. Systems were in place to support people to have a dignified death.
People received a well-led service. Staff had various opportunities including meetings to feedback their experiences and receive updates about the service. Any suggestions or concerns that staff had could be raised at one to one supervision meetings or at other occasions they contacted the office. Staff were supported by the registered manager who listened and acted upon any opportunity for improvement.
Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. People who used the service and their relatives were encouraged to share their views and feedback about the quality of the care and support provided and felt listened to. Actions were taken as a result of feedback to drive forward any improvements that were required.
Further information is in the detailed findings below.