Fortress Care Ltd

My Homecare Manchester is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people and younger adults with various needs, including people living with learning disabilities and dementia. At the time of this inspection 103 people were using the service.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support:

People received good quality care. The care plans provided guidance for staff about how best to support people's needs and preferences. Staff focused on people's strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People’s communication needs were met.

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; however, the systems in the service did not always support this practice. The provider had no specific mental capacity assessments in place. We have made a recommendation about the provider reviewing their systems in place to work within the principles of the Mental Capacity Act (MCA).

Right Care:

People received person-centred care of a good standard. People received kind and compassionate care. Staff were kind, caring and understanding. However, some people told us staff were not always respectful as they spoke in their mother tongue with each other whilst delivering care. We fed this back to the registered manager who assured us they would take necessary action and address this with staff.

Staff understood and responded to people’s individual needs. People's care needs were risk assessed and care plans provided staff with the information they needed to manage identified risks. People were protected from the risks of abuse and staff were trusted to keep them safe. Staff had received training in how to safeguard people. Medicines were managed safely.

Right Culture:

The culture of the service was friendly, open and inclusive. Person-centred values were embedded into the service and staff members we spoke with. People's choices were respected, and staff supported them to achieve good outcomes. Staff said they enjoyed their roles and the relationships between staff and people was positive. People told us they felt safe and knew how to raise concerns.

Overall, the provider ensured the safety and quality of the service was effectively assessed. However, there were areas which needed further development. The provider and registered manager were responsive to issues raised at the time of the inspection.

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 good (published 1 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Recommendations

We have made a recommendation about the provider reviewing their systems in place to work within the principles of the MCA.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

My Homecare Manchester is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to young and older adults. At the time of our inspection the service provided support for nine people. Eight people had commenced their support since August 2017.

My Homecare is a franchise company who provide central support to services through advice, policies and procedures and training to individual services such as My Homecare Manchester.

The service had a registered manager in place. 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 people who used the service and their relatives were very complimentary about the support provided by My Homecare Manchester. They said they felt safely supported by the My Homecare staff, who were kind and respectful, did not miss any support calls and completed all the tasks they were asked to do.

The staff enjoyed working for the service and said they were well supported by the registered manager.

People who used the service, their relatives and staff all said that the registered manager was approachable.

Care plans were person centred and included details of the agreed support required at each visit. Risks had been identified and guidelines put in place in order to mitigate the risks. Staff knew people and their needs well and were able to describe to us the support each person required. However we found care plans did not include much information about people’s likes, dislikes and hobbies.

The registered manager said they started supporting people within 24 hours of them being referred to the service. They completed an initial assessment and introduced staff to people before the support started.

Care plans and risk assessments were reviewed every six months or earlier if people’s needs changed. People and their relatives were involved in the initial assessment and reviews.

People received their medicines as prescribed. An assessment of people’s capacity to self-medicate was completed and the support they required clearly identified. All medicines administered by staff were recorded.

Where people had capacity they had signed their consent to the care plans. The local authority had assessed each persons need for support. Where people did not have capacity to consent to their support the local authority had agreed that the care and support was in their best interests. We have made a recommendation that My Homecare Manchester undertakes a capacity assessment as part of their review process and informs the local authority of any changes in a person’s capacity to consent to their care and support.

Staff had completed induction training with the registered manager prior to supporting people. They also shadowed another staff member so they could be introduced to the people they would be supporting and get to know their needs and the support they required. Additional training through on line courses had been completed.

Monthly supervisions were held with staff and team meetings were held. Spot checks were also completed with the registered manager observing staff during the support visits. A formal system of recording these checks was being introduced.

A system was in place to recruit suitable staff to be employed supporting vulnerable people.

A system was in place for recording and responding to complaints, incidents and accidents. No formal complaints had been received by the service. People and their relatives said they would contact the registered manager directly and were confident that any issues would be resolved.

All accidents and incidents were reviewed by the registered manager and the action taken had been recorded. The registered manager monitored the medicines administration records each month.

Feedback was sought from people using the service using monitoring forms. We saw the responses from people to date had been positive.

Staff supported people to ensure they had food and drinks available if agreed as part of the care plan. Staff explained how they would contact the person’s family if they thought the person they were supporting was unwell. This meant people were supported with their nutrition and health needs.