Majestic Healthcare Ltd

Updated 29 November 2022

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.

Inspection team

The inspection was carried out by one 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. The Expert by Experience made telephone calls to people and their relatives.

Service and service type

This service is a domiciliary care agency. It provides personal care to older people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post, however they are no longer working in the service and have applied to deregister with us.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 14 September 2022 and ended on 23 September 2022. We visited the location’s office on 14 September 2022.

What we did before the inspection

We reviewed information we had received about the service since it had registered with us, including notifications the provider had sent to us. We also gathered feedback from the local authority.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

During our inspection we spoke with three people and four relatives. We also spoke with the provider, deputy manager and ten care staff. We looked at the care records for twelve people. We checked that the care they received matched the information in their records. We looked at records relating to the management of the service, including audits carried out within service.

Updated 29 November 2022

About the service

Majestic Healthcare LTD provides personal care to older people living in their own homes. There were 55 people using the service at the time of our inspection.

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 did not always have care plans and risk assessments in place identifying what their individual needs were. Staff had also not always received training in these key areas to ensure they could support people in a safe way. We could not be assured people had received medicines when needed or as prescribed. People were not always supported by regular care staff and they were not always aware of who would be offering the support. People and relatives raised concerns that staff did not always know how to support them.

The systems in place were not effective in identifying concerns. The audits completed had not identified concerns we found during our inspection including with medicines and call times.

There were safeguarding procedures in place and when concerns had been identified these had been followed. Infection control procedures were also followed. 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. There was some evidence that lessons were learnt when things went wrong.

Staff’s suitability to work with people in their homes was checked before they started employment. They were happy with the staff that supported them and found them to be caring. People’s privacy and dignity was considered and maintained. They were encouraged to make choices and remain independent. Peoples’ communication was considered. There was a complaint policy in place, which was followed when needed.

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 26 June 2020 and this is the first inspection. During our inspection we found the provider was not registered at the correct location. The provider worked with us to update their registration. The provider registered with us on 25 October 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to Regulation 9 Person centred-care, Regulation 12 Safe care and treatment, Regulation 14 Meeting nutritional and hydration needs, Regulation 18 Staffing and Regulation 17 Good governance.

After the office site visit we issued the provider with a section 64 letter asking them what improvements they had made. We received a response from the provider which assured us they had taken action to ensure people were safe. This included, assessing people’s needs, completing care plans and risk assessments, updating medicines administration charts and training staff.

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