Archived: Morningside Care Ltd

Updated 11 September 2018

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.

This inspection took place on 20 and 21 August 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small service and the manager is often out of the office supporting staff or providing care. We needed to be sure that the manager would be available. The inspection team comprised of two adult social care inspectors. We visited the office location on 20 August 2018 to see the manager and office staff and to review care records and policies and procedures. The second day of the inspection was undertaken by one adult social care inspector and involved telephone discussions with people who used the service and their relatives about their views of the service and the quality of the support they received.

Before the inspection we asked the provider to 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 what improvements they plan to make. Prior to the inspection we reviewed information we held about the service and provider, including notifications the provider had sent us. A notification is information about important events which the provider is required to send us by law. We used this information to help us plan the inspection. We also asked the local authority and Healthwatch Bury for their views on the service. No concerns were raised with us.

During this inspection we spoke by telephone with four people who used the service, and the relative of one person, to seek their views about the service provided. With their permission we also visited one person who used the service in their own home. In addition, we spoke with the registered manager, the deputy manager and four care staff.

We looked at three care records, a range of documents relating to how the service was managed including medication records, staff training records, duty rotas, policies and procedures and quality assurance audits.

Updated 11 September 2018

This was an announced comprehensive inspection which took place on 20 and 21 August 2018.

This service is a domiciliary care agency. It provides the regulated activity personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of our inspection there were 5 people using the service.

At the inspections of the service in April 2016 and February 2017 we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At each of these inspections the service was rated as requires improvement. At the inspection in January 2018 we found that some of the required improvements from the last inspections had been met, however we identified two new breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach that was a repeat of one found during our inspection in April 2016. This was because medicines were not managed safely, care records had not always been reviewed or updated when people’s needs changed and systems in place to assess, monitor and improve the quality and safety of the service provided were not robust. We also made two recommendations; that the service improved the way they involved and informed people about staffing arrangements and the provider discuss any staff communication problems with people who use the service.

Following the last inspection, we imposed conditions on the provider’s registration that required them to complete an improvement action plan to show how they would improve the key questions; safe, effective, responsive and well led to at least good. The rating in the Well-led domain for this service was 'Inadequate.' Services that are rated as inadequate in one domain are inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

During this inspection we looked to see if the required improvements had been made. We found the breaches of regulations had been met and the required improvement had been made.

Medicines were managed safely. Staff had received training in medicines administration and had their competency checked regularly.

Detailed assessments of people’s support needs and preferences were made. Risks to people had been assessed. Care records were person centred, detailed and reflected peoples support needs. All care records had been reviewed regularly and changes made when needed.

People were involved in decisions about their care. The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA).

Significant improvement was found with the systems in place to assess, monitor and improve the quality and safety of the service provided. Due to the inspection history of the service evidence of sustained improvement was needed.

The 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. 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. The service had a registered manager, who is also one of the owners of the company. People who used the service and staff we spoke with were positive about the registered manager and told us improvements had been made in the way the service was organised and run. Staff told us they enjoyed working for the service.

People who used the service were encouraged to give their views on the quality of the service they received and how it could be improved.

Staff we spoke with were aware of safeguarding and how to protect vulnerable people. Staff were confident the registered manager would deal with any issues they raised. There were systems in place to protect people’s security and their property.

Visits were now well planned and people usually knew in advance which staff would be visiting.

People were very positive about the staff who supported them. They described staff as; nice, gentle, friendly and pleasant. People told us communication with staff had improved.

Staff knew people well and spoke in respectful terms about the people they supported. We observed staff interacted in a polite, respectful and good-humoured way with a person who used the service.

There was a safe system of recruitment in place which helped protect people who used the service from unsuitable staff.

There were sufficient staff to meet people’s needs and staff received the induction, training, support and supervision they required to carry out their roles effectively. Staff we spoke with liked working for the service and told us they felt supported in their work.

Suitable arrangements were in place to help ensure people’s health and nutritional needs were met.

Records of accidents, incident and complaints were kept. The service had notified CQC of any accidents, serious incidents, and safeguarding allegations as they are required to do. The provider had displayed the CQC rating and report from the last inspection on their website and in the home.