Cera - Norwich

Updated 7 March 2019

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.

We gave the service 48 hours’ notice of the inspection visit because it is a domiciliary care service and we needed to be sure that someone would be available to talk to us and arrange for people’s consent to be sought for us to contact them for their views. This inspection was undertaken by two inspectors, an assistant inspector 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.

Inspection site visit activity started on 17 January 2019 and ended on 5 February 2019. It included a visit to the provider’s office location on 17 January 2019 to meet with the registered manager and office staff; to review care plans and other records. In the following days we made telephone calls to people who used the service and their relatives, calls to members of staff and contacted healthcare professionals for their opinions of the service.

Before the inspection, we requested that the provider complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was received from the provider.

Providers are required to notify the Care Quality Commission about events and incidents that occur including unexpected deaths, injuries to people receiving care and safeguarding matters. Before the inspection we reviewed information that we held about the service such as statutory notifications. We also made contact with the local authority quality assurance team to seek their feedback to aid with our planning of this inspection.

During the inspection we spoke with 14 people who were receiving a personal care service from Mears Care (Norwich). We also spoke with the relatives of 16 people. We spoke with 15 members of care staff as well as the registered manager, the visiting officer, the administration/recruitment officer, the trainer, two care co-ordinators and a senior carer. Following our visit, we left our contact details for any other staff wishing to contact us and provide feedback on the service, however none did.

We reviewed five people’s care records in detail including their daily records and where applicable, their medicine administration records (MAR). We looked at four staff recruitment files. We also looked at other records including training records, meeting minutes and quality assurance records.

Updated 7 March 2019

Mears Care (Norwich) is a domiciliary care service providing personal care to people living in their own home in Norwich and the surrounding areas. It provides a service to people living with dementia, younger people and people who may misuse alcohol or substances.

Inspection site activity commenced on 17 January 2019. At the time of inspecting 221 people were receiving a regulated activity. Not everyone using Mears Care (Norwich) receives a regulated activity; CQC only inspects the service being provided by people with 'personal care; help with tasks related to personal hygiene and eating.

The service had a registered manager in place. They were present throughout the inspection. 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.

At our last inspection we rated the service ‘Requires Improvement’. At that inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We were concerned that the systems in place around monitoring the administration of medicines were not fully effective, and we could not be assured they were always managed safely. We were also concerned at our last inspection that there were no systems in place to check that the content of people’s care plans was relevant with enough individualised guidance for staff to follow. We also had found that people's visit times were not always carried out at the agreed times and for the agreed length of time. People's preferences were also not always being met and care records did not always contain sufficient guidance for staff with regards to people's individual risks around specific health conditions or behaviours. People's mental capacity was not assessed for specific decisions, and there were no records of best interest’s decisions for those people who did not have full capacity. People knew how to complain; however, some people did not feel comfortable to do so.

At this inspection we found that improvements had been made and that the service was no longer in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered manager and staff team had taken on board the feedback we had provided and had worked hard to make the necessary changes. Between our inspection on 17 June 2017 and the current inspection commenced on 17 January 2019 the registered manager and substantially reduced the number of people they were providing a personal care service to in order to work on improvements and embed new practices. At this inspection we have rated the service ‘Good’ overall.

People felt safe with the service they received and were confident with the knowledge and skills of the care staff that supported them. Staff were well trained and had observations of their practice carried out at frequent intervals. Staff knew what abuse and harm was and they were also aware of how to report any concerns if they had them. People were positive that they consistently received their care calls however these were on occasion late resulting in two people telling us they had been unable to have their meal at their planned time. People couldn’t always have their care at their choice of time.

Staff managed people’s medicines in a safe way and were trained in the safe administration of medicines. Staff understood the need to protect people from the spread of infections. People were supported to maintain good health. Staff responded appropriately if people's health deteriorated or they felt unwell and staff made sure they contacted the appropriate professionals to ensure people received effective treatment.

People felt that staff treated them with kindness and were caring in their approach to supporting people. People had their privacy and dignity respected by staff. Feedback from people and relatives indicated that positive relationships had developed between people and care support staff.

There were effective systems in place to monitor the quality of care and support that people received. The provider had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained. Plans were in place and been commenced to update the care planning system to a new electronic format.

Systems were in place to obtain feedback from people about the quality of the service they received through satisfaction surveys and frequent review meetings. Audits had been carried out in relation to care documentation, staff files and medicines. The aim of this audit was to look at the overall running of the service. Feedback from people and their relatives was welcomed. People and their relatives knew who to contact if they needed to raise a concern or a complaint. There were opportunities for people to provide their feedback about the service they received.