Archived: Meadowsweet Home Care

Updated 21 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was 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.

The inspection took place on the 26 and 27 April 2016 and was announced. The provider was given 48 hours' notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies.

The inspection was undertaken by two adult social care inspectors.

It should be noted that the provider was not requested to complete a provider information return (PIR) prior to the inspection. This is a form that asks the provider to give some key information about Meadowsweet Home Care. We also looked at all the information which the Care Quality Commission already held about the provider. This included previous inspections and any information the provider had notified us about. We invited the local authority to provide us with any information they held about for Meadowsweet Home Care. We took any information provided to us into account.

During the inspection we spoke to the registered manager and office manager at Meadowsweet Home Care. We encouraged people using the service to communicate with us using their preferred methods of communication, and we attempted to speak with all people using the service, or their relatives. We undertook two home visits, by invitation, to people who received a service from Meadowsweet Home Care. On the second day of the inspection we spoke by phone with two relatives and ten people who received the service. We also attempted to speak with nine staff (support workers) employed by Meadowsweet Home Care, however only four staff were available to speak to us.

We looked at a range of records including three care plans belonging to people who used the service. This process is called pathway tracking and enables us to judge how well the service understands and plans to meet people's care needs, as well as how any risks to people's health and well-being are managed. Examples of other records viewed included: policies and procedures; four staff files; complaint and safeguarding logs; rotas and / or visit schedules; staff training and audit documentation.

Updated 21 June 2016

This inspection was announced and took place on the 26 and 27 April 2016. The service was previously inspected in October 2013 when it was found to be meeting all the regulatory requirements which were inspected at that time.

The office for Meadowsweet Home Care is located in Knutsford, Cheshire. Meadowsweet Home Care is a domiciliary care service that is registered for the regulated activity of personal care. The service provides care and support to people in their own homes. At the time of inspection there were 22 people using the service.

At the time of the inspection there was a registered manager at Meadowsweet Home Care. 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.

During this inspection we found three breaches of the Care Quality Commission (Registration) Regulations 2009 and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take as the back of the full version of the report.

Risk assessments were in place but were not always robust in identifying what control measures were in place or what action staff should take to minimise potential risks.

Management of medicines was inconsistent and staff did not always follow the provider policy in the recording of medicines. Records of medication administration were not always fully completed and there were inadequate systems to audit these records, to highlight any errors or omissions.

The staff and registered manager had not received training on the Mental Capacity Act 2005 and lacked awareness of this protective legislation.

The service lacked governance systems to assess, monitor and improve the quality of the service. There were shortfalls identified during this inspection that had not been identified by the provider or registered manager.

Staff had been recruited safely to the service and had undergone the correct pre-employment checks before commencing work with the service.

There were sufficient numbers of staff on duty to meet people's needs.

People told us they felt safe when support workers were in their homes and that they were treated with kindness and compassion.

Staff we spoke with were able to tell us about ways in which they protected people's privacy and dignity whilst undertaking personal care tasks. We spoke with people who used the service and their relatives about their experience, they confirmed that care workers were respectful.

The registered provider did not have a whistleblowing policy available to provide staff with guidance if they ever needed to raise concerns about their organisation. The registered provider has not yet introduced the Care Certificate new minimum standards to new and existing staff. The registered provider would benefit from developing a clear overview of complaints received, action taken or outcomes. A business continuity plan had not been developed to ensure an appropriate response would be followed in the event of an emergency. Contemporaneous records were not accurate and completed to provide a clear record of what support has been provided. We have made recommendations about these areas in the report.