Medacs Healthcare - London

Updated 12 March 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and two 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.

Service and service type

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

The service had a manager registered with the Care Quality Commission. 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.

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

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 reviewed information we held about the service, including previous inspection reports, feedback from people and their relatives and information the provider was required to send to us including notifications of incidents that took place within the service. We used all of this information to plan our inspection.

During the inspection

We spoke with 18 people who used the service and 17 relatives of people who used the service. We also spoke with six members of staff, the registered manager and managing director. We looked at eight people’s care records, three staff files and a selection of records relevant to the management of the service such as service audits and staff training records.

After the inspection

We looked at further records we had asked the registered manager to send to us. These included satisfaction surveys the provider had carried out and a selection of additional care records.

Updated 12 March 2020

About the service

Medacs Healthcare Croydon is a domiciliary care agency providing personal care and support to 311 people living in their own homes at the time of the 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

At our last inspection, we found systems to manage risks and staffing were inadequate and the provider was in breach of the regulations in relation to safe care and treatment, staffing, receiving and acting on complaints and good governance. At this inspection we found the quality of the service had improved significantly. Some improvements were still required, but the provider was no longer in breach of the regulations.

People felt safe using the service. Each person had a detailed risk management plan which was personalised, although these did not always consider how some health needs were connected and might increase risk.

We have made a recommendation about the use of standardised pressure area risk assessment tools.

There were enough staff to safely cover all care visits, which usually happened on time although some improvements to punctuality were required. The provider used safe recruitment systems to help ensure people only received care from suitable staff. There were effective systems in place to protect people from risks associated with abuse and neglect, infection and the unsafe management of medicines.

Improvements to the provider’s quality assurance system meant the registered manager was already aware of and was working on several areas they needed to improve. This included communication between care staff and office staff, which people felt was not always good. Leadership was visible and the provider was open and honest when things went wrong, making sure they learned lessons and acted to prevent things going wrong again. The provider sought and acted on feedback from people, their families and staff.

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. The provider assessed the capacity of people to make decisions about their care in line with relevant legislation.

Staff knew how to provide appropriate care at the end of people’s lives and listened to what people said they wanted at this time. We have made a recommendation about exploring and recording these preferences in advance.

People had detailed assessments to allow care to be planned and delivered in line with guidance. Staff worked well with other agencies to do this and made sure people had the support they needed to stay healthy and eat well. Staff received the support and training they needed to care for people effectively.

The provider had improved their systems for responding to people’s complaints and concerns. People were satisfied with how their complaints were handled. The care and support people received was personalised and met their needs, and people were generally happy with it. People received information in suitable formats so they understood it. The provider took steps to protect people from the risk of social isolation.

The provider had made improvements to how staff were deployed, meaning people were more consistently supported by the same staff and were able to build good relationships with them. People and their relatives were involved in planning care and their views were listened to. People received the support they needed from kind, caring and respectful staff who promoted dignity and independence.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 18 July 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.

This service has been in Special Measures since 10 January 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.