Metro Homecare Ltd

About the service

Metro Homecare Ltd is a domiciliary care service providing personal care to people in their own homes. At the time of this inspection, 63 people were receiving a 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

Right Support:

The model of care maximised people’s choice, control and independence. People lived in their own flats and houses where they felt safe and comfortable. Staff supported people to in line with their preferences and wishes. People were protected from the risks associated from the spread of infection. People were encouraged to make choices and decisions in accordance with their level of understanding.

People were supported by enough appropriately skilled staff to meet their needs and keep them safe. People’s risks were assessed in a person-centred way. Care plans and risk assessments were regularly evaluated, involving the person, relatives and other professionals as appropriate. Systems were in place to report and learn from any incidents or accidents. Staff were recruited safely and there were enough staff on duty to meet people’s needs.

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; the policies and systems in the service supported this practice.

Right Care:

Care was person centred and promoted people’s dignity, privacy and human rights. People were protected from abuse and poor care. Staff understood how to deliver a kind and compassionate care service. People and relatives told us care staff were caring and office staff were as kind as care staff. People were supported to maintain their privacy, dignity and independence by staff who knew them well.

People’s communication needs were met and information was shared in a way that could be understood. Staff supported people with activities of their choice as appropriate. People were supported to maintain links with their culture and their spiritual needs were met. Support focused on people’s quality of life and followed best practice.

Right Culture:

The ethos, values, attitudes and behaviours of leaders and care staff ensured people using the service lead confident, inclusive and empowered lives. The registered manager had an open door police and people, relatives and staff spoke positively about the management of the service. People, relatives and staff told us they felt comfortable raising concerns and making suggestions to enable improvements to be made to the service.

Managers ensured staff had relevant training, supervision and appraisal. Governance systems ensured people were kept safe and received a high quality of care and support in line with their personal needs. The provider asked people, relatives and staff about their opinions of the service. Staff worked well with other professionals to improve outcomes for people.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 5 June 2019) and there were breaches of regulation. 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.

At our last inspection, we recommended the provider consider current guidance in relation to record keeping in line with the MCA. At this inspection we found the provider had acted on our recommendation and had made improvements.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This inspection was carried out to also follow up on action we told the provider to take at the last inspection.

Follow up

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

Metro Homecare Ltd 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 the whole population. Not everyone using Metro Homecare Ltd receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of the inspection, it was providing a service to 279 people.

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

People’s experience of using this service:

People told us they felt safe with the staff. However, some people and their relatives felt weekend and temporary staff did not always know people’s needs.

The provider had not always identified risks to people who used the service or put in place guidance on how to reduce risks where these were identified. The provider had not always updated people's risk assessments to reflect their changing needs.

People were at risk because guidance and the potential risks on how to support people with medicines was not always recorded clearly in their support plans.

Staff followed appropriate procedures in seeking people’s consent however the provider was not always recording consent in line with the Mental Health Act 2005 (MCA).

The provider lacked robust and effective systems and processes to ensure the quality and safety of service.

People and relatives told us staff were caring and treated them with dignity and respect. They were involved in the care planning process and reviews. People's independence was encouraged and maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People and relatives knew how to raise concerns and they told us the service was responsive.

Staff told us they felt supported and were involved in continuously learning and improving care.

Rating at last inspection:

The service was registered by CQC on 27 April 2018. This is the service’s first inspection since its registration. This is the first time this service has been rated Requires Improvement.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Enforcement:

We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care and treatment, and good governance. Details of action we have asked the provider to take can be found at the end of this report.

We made one recommendation in our inspection report, which we will follow up at our next inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.