Midcare Services Ltd

Updated 20 November 2019

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 team comprised of two inspectors

Service and service type

Medicare is a domiciliary care service providing personal care to people in their own homes.

The service had a manager registered with the Care Quality Commission who was also the provider. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection took place on 10 October 2019. We gave the registered manager short notice of the inspection visit because the staff and the management team are often out of the office supporting staff or providing care. We needed to be sure that they would be in.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection. This included details about incidents the provider must notify us about. We also sought feedback from the local authority and professionals who work with the service. We reviewed the information we require providers to send us at least once annually to give some key information about the service, what the service 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. We looked at four care records, and four staff records, which included recruitment records. We looked at complaints, incidents and accident records. We also looked at records in relation to how the service is monitored and reviewed.

Following the inspection, we spoke with 11 people who use the service and two relatives and five staff.

Updated 20 November 2019

About the service.

Midcare is a domiciliary care service. It provides personal care to people living in their own homes. On the day of inspection, the agency was supporting 30 people. There was a registered manager in post. '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.'

People's experience of using this service and what we found

The registered manager who is also the provider did not have appropriate systems in place for gathering reviewing and evaluating information about the quality of the service provided.

There was a complaints procedure to enable people to make complaints and people spoken with were aware of these procedures. People told us they felt that the registered manager and staff would address any concerns they had. We saw when complaints were made the registered manager did not always follow their own complaints procedure to ensure a full investigation was completed.

Recruitment checks were completed and included checks with the Disclosure and Barring Service. (DBS) to ensure staff were suitable to work with people. However, staff that required a visa to work in the UK were not always reviewed to ensure they continued to work within the law. The registered manager assured us that checks were made but had not recorded this. The registered manager assured us this would be documented in the future.

People told us they felt safe with the staff who supported them. People told us that staff were kind and considerate. Relatives spoken with told us that the staff were respectful.

People had support with their medication when required from staff. Staff had completed training in the safe administration of medication to ensure people were supported by experienced staff who had the right skills.

People had their care needs assessed to ensure the service could meet their needs. These included risks associated with people's care and how they wanted staff to support them.

Staff were aware of how to protect people from the risk of abuse and confirmed who they would report to if they had any concerns, including external agencies if required. People confirmed the care they received met their individual preferences and choices. Care plans were reflective of people's current needs.

People and their relatives told us that staff were very kind and caring and treated them with dignity and respect.

Rating at last inspection: The last inspection was completed on 30 March 2017 and was rated as Good. Published (27 April 2017)

Why we inspected: This was a planned inspection.

Enforcement: We have identified breaches in relation to the governance processes at this inspection. 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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