Archived: Mears Care Brighton

Updated 7 February 2017

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 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 14 November 2016 and was announced. We told the provider two days before our inspection that we would be coming. This was because we wanted to make sure that the registered manager and other appropriate staff were available to speak with us on the day of our inspection. Two inspectors undertook the inspection, with an expert-by-experience, who had experience of older people’s care services. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience helped us with the telephone calls to get feedback from people who used the service and relatives.

Before the inspection, we reviewed information we held about the service. This included previous inspection reports, and any notifications, (A notification is information about important events which the service is required to send us by law) and any complaints we have received. This enabled us to ensure we were addressing potential areas of concern. We telephoned the local authority commissioning team, who have responsibility for monitoring the quality and safety of the service provided to local authority funded people. We also received feedback from two social care professionals about their experiences of the service provided. We spoke with 17 people and one relative who used the service.

During the inspection we went to the services office and spoke with the registered manager, the regional recruitment officer, a visiting officer, two care co-ordinators, a senior care worker, and five care staff. We spent time reviewing the records of the service, including policies and procedures, ten people’s care and support plans, the personnel records for three care staff, complaints and compliments recording, accident/incident and safeguarding recording, and staff rotas. We also looked at the provider’s quality assurance audits.

This was the first inspection since a new provider took over the service.

Updated 7 February 2017

This inspection took place on 14 November 2016 and was announced. This was the first inspection since the service was re-registered following a new provider taking over the service and a change in name. This service was formerly Brighton Community Care Services DCA.

Mears Care (Brighton) is a domiciliary care agency and provides personal care and support for people living in their own home in the Brighton and Hove area. Care was provided to adults but predominantly older people, including people with a physical disability or learning disability, people with a sensory loss, for example hearing or sight loss and people with mental health problems or living with dementia. At the time of our inspection around 130 people were receiving a service.

The service had a registered manager, who was present for the inspection. 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.

This inspection was carried out due to the number of concerns the CQC had received about the service provided in relation to missed calls and the time care calls were being provided. Staff told us there had been a significant period of change in the management arrangements and personnel working in the office leading to staff vacancies of senior staff and care staff. The registered manager had recently been registered to also be the registered manager for another of the provider’s services and split their time between both these services offices. The registered manager was on site two days a week. They were contactable when not on site. However, feedback from people and care staff demonstrated there was a lack of clarity of the management arrangements for the service. The current management arrangements did fully support the operation of the service. Procedures such as care and support plan reviews, quality assurance checks, spot checks of care staff at work, staff supervision, team meetings and staff appraisal, investigations into concerns and complaints raised and quality assurance audits had fallen behind and not been fully completed to meet the provider’s timescales. People told us there had been a period of a lack of consistency of times the care calls were provided. The registered manager told us about the difficulties in recruitment of new care staff had led to the use of agency staff to help cover care calls. This had led to a lack of consistency in the care staff covering people’s care calls. Because of this people told us they did not always feel care staff understood their care and support needs. One member of staff told us, “If you have regular carers, it runs smoothly, but it’s not happening as much as it should be. It’s important for people with dementia to have continuity. They just want a face that they know, but that’s not happening at the moment.” Care staff told us there was a lack of sufficient travel times between care calls to ensure people’s care was delivered at the time agreed. Where people had raised concerns the feedback was varied when asked if they felt their concerns had been resolved. We have asked the provider to make improvements in all these areas.

Consent was sought from people with regard to the care that was delivered. All staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005 (MCA), and had taken appropriate action to arrange meetings to make a decision within their best interests. Staff told us they always asked for people’s consent before they provided any care and support. One member of staff told us, “Absolutely it’s all about choice. We’re not there to tell people what to do. I make adjustments every day to give them what they want.”

Where required, care staff supported people to eat and drink and maintain a healthy diet. People were supported with their healthcare needs. One member of staff told us, If somebody is not well I will call the office or call an ambulance. I would record it and ask the next carer to check on the person as well.” Medicines were managed safely and people received the support they required from staff.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of this report.