Mercie Grace

Updated 6 December 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.

Inspection Team

The inspection was carried out by 2 inspectors. Two Expert by Experience made telephone calls to people using the service and their relatives. 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.

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

We gave the service 48 hours’ notice of the inspection. 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 the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager, care manager, administrator, finance and administration manager, 2 care coordinators and 3 care workers. We also contacted a further 30 care staff by email for feedback and received 26 responses. We contacted external health and social care professionals for feedback and received 5 responses. We spoke with 4 people who used the service and 15 family members for their experience of the service.

We reviewed a range of records. This included 9 people’s care records, 3 staff files in relation to recruitment, and medicines records. A variety of records relating to the management of the service, including policies and procedures, staff training, meetings records and audits and checks.

Updated 6 December 2023

About the service

Mercie Grace provides care to people living in their own homes. 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. At the time of our inspection, 87 people were receiving a service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Care plans and risk assessments provided staff with guidance of how to provide safe care and support and mitigate known risks. However, care plans were not consistently kept up to date when changes occurred.

People were supported with their prescribed medicines. The provider had taken some actions to make improvements to medicines management and further actions were required. We made a recommendation about medicines management.

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.

Overall, care calls were delivered within the time expected, by a regular core group of staff, who stayed for the duration of the call.

Staff had been recruited safely, and staff received an induction, training and ongoing support. Additional staff training in learning disability and autism was required and the registered manager took immediate action during the inspection to arrange this.

Right Care: People were positive about the kind, caring and respectful approach of care staff. People were involved as fully as possible in discussions and decisions about their care.

Where required, people were supported with eating and drinking. People’s health was monitored, and action was taken if a person’s health needs changed.

People received care and support based on their individual needs, routines and preferences. People’s diverse needs were considered and met. This included their individual communication needs and preferences.

People had access to the provider’s complaint procedure. Complaints and incidents were investigated, and actions taken to make improvements.

Right Culture: There was a positive staff culture and partnership working with external agencies. The provider sought and valued feedback from people and staff.

The providers systems and processes were not always effective in helping to identify where improvements were required. However, improvements had been made and were ongoing in developing staff roles and responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service was requires improvement (published 19 June 2021). Since this rating was awarded the provider has altered its legal entity and premises. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

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

Enforcement

We have identified a breach in regulation in relation to the governance of the service.

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.