Background to this inspection
Updated
5 February 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 service was inspected by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
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. Inspection activity started on 9 July 2019 and ended on 21 August 2019. We visited the office location on 10 July 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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.
During the inspection-
We spoke with two relatives of people who use the service about their experience of the care provided. We were not able to speak with people using the service as they were not able to communicate with us. We spoke with two care workers, the deputy manager and the registered manager.
We reviewed a range of records. This included three people’s care records, three staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service, including quality assurance records.
After the inspection –
We continued to seek clarification from the provider to validate evidence found. We looked at training data and reviewed policies and procedures. We communicated with one professional who visited the service.
Updated
5 February 2020
About the service
Mooncare is a domiciliary care service providing personal care to five people at the time of the inspection. The service provided care for people with learning disabilities, but was also available for people with other needs. 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.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The provider assessed the risks to people’s health and safety and had clear, written risk management guidelines in place. People were safeguarded from the risk of abuse as care workers had received training in how to recognise this and knew what to do if they suspected someone was being abused. Care workers had received infection control training and demonstrated an understanding of good practice. The provider was not supporting anyone with their medicines, but did have an appropriate medicines administration policy and procedure in place if they were required to do this in the future. The provider had a clear accident and incident policy and procedure in place, but there had not been any accidents since the last inspection.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported appropriate practice, but were not being followed.
The provider was not always meeting the requirements of the Mental Capacity Act 2005 as they were not completing mental capacity assessments to determine whether people were able to consent to their care. People’s care was not always given in line with current standards as the provider was not meeting the requirements of the MCA 2005, but was meeting appropriate standards in other areas.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People’s care plans did not always contain enough information about their likes and dislikes in relation to food, but the manager told us she would update these. However, despite the lack of written recording in this area, care workers demonstrated they knew people well and understood their preferences. Care workers received appropriate support in the form of an induction, training, supervisions and annual appraisals to conduct their roles effectively.
People spoke positively about their care workers and told us they had a good relationship. People’s care records contained a sufficient amount of information about their religious and cultural needs. Care workers showed people respect and protected their dignity.
At the time of our inspection, the provider was not supporting anyone with their end of life care needs. However, the provider written details about people’s needs in the event of a sudden death. The provider supported people appropriately with their recreational needs and communication needs. There was a suitable complaints policy and procedure in place.
The provider had good processes for monitoring the quality of the service. The registered manager understood her duty of candour responsibilities, as well as her responsibilities in relation to the service, but was not clear about her responsibility to conduct mental capacity assessments. The provider worked effectively with other professionals.
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 this service was ‘requires improvement’ (published 9 July 2018) and there were three breaches of regulations. 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.
Why we inspected- This was a planned inspection based on the previous rating.
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.