Mayden Support

Updated 16 June 2022

The inspection

We carried out this focused inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act under the domains of safe and well-led, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

This inspection was undertaken by two inspectors and an 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 service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

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

Notice of inspection

This inspection was unannounced.

Inspection activity started on the 20 April 2022 and ended on 25 April 2022. We visited the service location on 20 April 2022.

What we did before the inspection

We reviewed information received about the service since the last inspection. We liaised with the Local Authority Safeguarding Team with regards to the concerns raised by them in respect of the provider. We used all this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke five people using the service and/or their relatives. We spoke with the regulated provider, registered manager and the care co-ordinator. We reviewed a range of records including five people’s care records, a sample of medication records, six staff recruitment files and records relating to the management of the service.

After the inspection visit

Due to the impact of the COVID-19 pandemic we limited the time we spent on site. Therefore, we requested records and documentation to be sent to us and reviewed these following the inspection visit remotely. We continued to seek clarification from the manager and provider to validate evidence.

Updated 16 June 2022

About the service

Mayden Support is a domiciliary care service that provides support and personal care to adults in their own homes. Not everyone who used the service received personal care. At the time of our inspection 20 people received support with their 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

During the inspection, we found that the provider had recruited a senior member of staff without following a safe recruitment process. This led to an unsafe appointment and placed people at potential risk. At the time of our inspection, this person no longer worked for the service. Care staff recruited by the manager had however been recruited safely.

Medication management was not safe. There were no adequate systems in place to check that people’s medicines were administered as prescribed. Medication administration records were not accurate, and information relating to people’s medication needs was not up to date or accurate.

People’s needs and risks had not been adequately assessed and care plans had not been updated appropriately, when people’s needs and visit preferences had changed.

People’s visits times did not always correspond with the visit times they had agreed with the service. Visits were sometimes much later or earlier than agreed. Records relating to the length of time staff spent providing support to people, were also not accurate. This lack of accurate record-keeping made it impossible to tell if people’s visits were occurring as planned in order to mitigate and manage risks.

The provider had a policy in place with regards to COVID-19. Staff testing for the virus at the time did not adhere to government guidelines in place at the time of the inspection.

There were limited systems in place to monitor and audit the quality and safety of the service. This meant they did not identify the concerns we found during the inspection. The manager and provider failed to have sufficient oversight of the service to monitor and mitigate risks to people’s health, safety and welfare. The provider had also not always acted with respect for the duty of candour at all times.

People and their relatives said staff were kind, caring and supportive. They said that it was easy to get in touch with ‘the office’ to speak to someone if they needed to and that they were happy with the support they received from staff.

Rating at last inspection and update

The last rating for this service was good (published 01 October 2021). At the last inspection the domains of safe and well-led were rated good. At this inspection, the domain of safe had deteriorated to inadequate and the domain of well-led to requires improvement. A breach of regulation 12 (Safe care and treatment), regulation 19 (Fit and proper persons) and regulation 17 (Good governance) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified.

Why we inspected

We received concerns from the Local Authority in respect of the recruitment of a senior member of staff. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mayden Support on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner. We will work with the local authority to monitor progress.