McNeil Homecare Limited

188 Upper Luton Road is a small domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older and younger adults, including people with dementia and physical disabilities.

Not everyone using the service receives 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, there were five people receiving the regulated activity of personal care from the service.

At our last inspection, the service was rated Good. At this inspection we found the service remained Good.

There continued to be a registered manager in post. 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.

People continued to receive care that was safe. Staff understood their roles and responsibilities to safeguard people from the risk of harm and risks to people were assessed and monitored regularly.

There continued to be enough suitably qualified staff available to meet people's needs. The service was flexible and responded to people's changing needs. People told us they were able to request their visits at agreed times. People and relatives we spoke with told us they had never experienced a missed care visit.

People continued to receive care from staff that were caring, kind and compassionate. People were treated with dignity and respect and staff ensured their privacy was maintained.

People were encouraged to make decisions about how their care was provided. Staff had a good understanding of people's needs and preferences.

People’s needs continued to be assessed, their care provided in line with up to date guidance and best practice. People’s cultural and religious needs were taken into consideration at the time of assessment.

People received care from staff that had received training and support to carry out their roles.

Risks continued to be assessed and recorded by staff to protect people. There continued to be systems in place to monitor incidents and accidents. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

Staff continued to support people to attend appointments with healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.

Staff told us that they seek guidance from healthcare professionals as required. They told us they would speak with people’s families and inform the manager if they had any concerns about people’s health.

Staff understood the Mental Capacity Act 2005 and how to support people's best interest if they lacked capacity. People continued to be supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff continued to have good levels of support and supervision to enable them to carry out their roles. There was a programme of planned training which was relevant to the work staff carried out and the needs of the people using the service.

Staff continued to be recruited safely through a robust recruitment and selection process. This enabled the provider to select staff that were suitable to work with vulnerable people. Staff received an induction which included mandatory training and shadowing experienced staff.

The provider had a system in place to ensure people received their medicines as prescribed. Staff continued to receive training to administer medicines safely and staff spoke confidently about their skills and abilities to do this well.

There continued to be policies in place which ensured people would be listened to and treated fairly if they complained. The provider had a robust process in place to enable them to respond to people and their concerns, investigate them and had taken action to address their concerns.

The service had an open culture which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to drive improvement.

Procedures for reporting safeguarding concerns continued to be in place. The provider knew how and when they should escalate concerns following the local authorities safeguarding protocols.

The provider continued to have processes in place to monitor the delivery of the service. People’s views were obtained through surveys, one-to-one meetings, meetings with people’s families and meetings with social workers.

Quality assurance audits continued to be carried out to identify any shortfalls within the service and how the service could improve.

Staff continued to have access to an ‘out of hours’ support that they could contact during evenings and weekends if they had concerns about people. The service could continue to run in the event of emergencies arising so that people’s care would continue.

The provider and staff were committed to the values and vision of the company and they took these into account when delivering care and support.

Further information is in the detailed findings below.

188 Upper Luton Road provides personal care to older people, including people with dementia and physical disabilities in their own home and support in the community. The agency provides care for people in the Medway area. There were six people receiving support to meet their personal care and community support needs on the day we inspected.

The service had a registered manager. 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.

People were protected against the risk of abuse. Staff recognised the signs of abuse or neglect and what to look out for. Both the registered manager and staff understood their role and responsibilities to report any concerns and were confident in doing so.

Risk assessments were detailed and gave staff guidance about any action staff needed to take to make sure people were protected from harm.

Effective recruitment processes were in place and followed by the registered manager Staff had the opportunity to discuss their performance during one to one meetings and annual appraisal so they were supported to carry out their roles.

There were suitable numbers of staff on shift to meet people’s needs. People’s planned care were allocated to members of staff and at appropriate times.

Staff received regular support and supervision from the registered manager. Staff had received training relevant to their roles.

People were supported and helped to maintain their health and to access health services when they needed them.

People told us staff were kind, caring and communicated well with them. People’s information was treated confidentially. Paper records were stored securely in locked filing cabinets.

Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) was in place which included steps that staff should take to comply with legal requirements.

People’s view and experiences were sought through review meetings and through surveys. People’s views about the service they received were positive.

People were supported to be as independent as possible. People had access to additional resources through the service to prevent loneliness.

People told us that the service was well run. Staff were positive about the support they received from the registered manager. They felt they could raise concerns and they would be listened to.

Audit systems were in place to ensure that care and support met people’s needs.

Communication between staff within the service was good. They were made aware of significant events and any changes in people’s behaviour.

People were made aware of the complaints system. This was provided in a format that met their needs.

Before people received any care or treatment, they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. People told us their care and support needs had been agreed with them before the service started. People we spoke with understood the care choices available to them. One person said, 'They carried out our care needs assessment before the service started. Yes, we were given enough information before the service started'.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Comments from the person we spoke with on the telephone included, 'It has been absolutely good. I have been well pleased' and 'They do more than expected and they are friendly'.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening

There were no effective recruitment and selection processes in place.

People were not made aware of the complaints system. This was not provided in a format that met their needs.