MHA Care at Home - Wesley Branch

Updated 13 February 2024

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care [and support] service.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 20 November 2023 and ended on 7 December 2023. We visited the location’s service on 27 November 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We reviewed information we received from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person who uses the service and 2 relatives. We spoke with 4 staff, including 3 care staff and the registered manager. We reviewed a range of records. This included 3 people's care records including medicine records. We looked at 2 staff files in relation to recruitment. We also viewed a variety of records relating to the management of the service, including audits, risk assessments and policies and procedures.

Updated 13 February 2024

About the service

MHA Care at Home – Wesley Branch is an extra care service. The service provides personal care to older people who live in their own apartments in a modern building. At the time of our inspection there were 12 people 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

The provider's quality assurance system was not always effective and had not led to actions to improve the service or mitigate risks. Audits did not always identify shortfalls and where they did, actions were not always completed.

Medicine records were not always completed in line with the provider’s policy and did not accurately reflect medicine administered. Staff told us they had raised concerns with management about the safe management of medicines. Staff were unsure what had happened as a result of those concerns.

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 policies and systems in the service did not always support this practice. For example, we found conflicting information regarding Lasting Power of Attorney in people’s care and support records.

People felt positive about the care they received and felt the staff were friendly and kind. They told us they felt safe and were looked after by a consistent team of people. They told us the registered manager was very approachable and responded to concerns or queries in a prompt and efficient manner.

Staff told us this was a positive place to work and they felt supported by their colleagues and the registered manager was approachable and they could speak up if they needed to. Staff had training, including safeguarding and felt they had the skills and abilities to keep people safe. There were enough staff to support the people living there.

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 October 2018).

Why we inspected

We carried out this inspection due to the length of time since the last inspection.

This report only covers our findings in relation to the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for MHA Care at Home – Wesley Branch on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management and effective governance at this inspection.

We have made recommendations in the safe key questions in relation to the Mental Capacity Act. Please see these sections for further details.

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