Archived: Mach Care Solutions (Birmingham)

We looked at information to help us gather evidence about the quality of the provider's care and support to people that used the service. On the day of our inspection, the provider told us that 94 people received care and support.

We spoke with 10 staff members and with 16 people or their relatives that used the service. Our conversations with people helped us to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? and, Is the service well led?

Below is a summary of what we found.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

All of the people that we spoke with told us that they felt safe with staff supporting them. One relative told us, 'I feel that my family member is safe with staff supporting them in their home.'

There was a system in place to record accidents and incidents. Staff spoken with told us that they would phone the manager to report an accident. The operations manager told us that they had not received any reports of any accidents.

There was a system in place to handle concerns and complaints. The provider told us that 17 complaints had been received since our last inspection in February 2014. Most people that we spoke with told us that if they had a complaint they would phone the provider. One person told us, 'I had to complain about a few issues but things have improved.'

We sampled some staff files and found that they were disorganised. Some contained the required pre-employment checks but some did not. The provider was not able to locate all of the information that we asked to look at. This meant that the provider could not evidence that all workers employed were suitable to work with vulnerable adults.

Is the service effective?

All of the people that we spoke with told us that they were happy with the care and support received from the staff that attended their calls. However, most people told us that they felt the day to day management of the service could improve. One relative told us, 'The care staff do their best and we are happy with them. However, the management need to improve. They have previously forgotten to cover calls when the usual carer is off. Communication needs to improve.'

We found that some improvement had been made since our last inspection. However, this was not always effective and did not met all of the regulations inspected. We have asked the provider to send us an action plan to tell us how they will implement further improvement.

Is the service caring?

All of the people spoken with told us that they felt the staff that attended their care and support calls to their house were caring. One person told us, 'The carer is kind.'

We found that people's experience of being asked for feedback about the quality of the service provided was inconsistent. One person told us, 'I had a phone call to ask me if I was happy with everything recently.' Another person told us, 'I've never been asked for feedback since the start of the service.'

Is the service responsive?

Most relatives spoken with told us they had no concerns or complaints. One relative told us, 'I find the manager approachable. If I had any concerns I would speak with them.'

Is the service well led?

Some people and their relatives that we spoke with did not feel that the service was well led. One relative told us, 'The management need to improve their communication.'

There were some systems of audit in place but we found that these were not always effective. We found that some audits we were told took place could not be evidenced by the provider.

Most records were not easily located and some that we asked for such as people's daily care logs were not located. The operations manager told us they did not know where they were. We were not able to look at staff timesheets because copies had not been retained by the provider.

The provider confirmed that at the time of our inspection the service was not providing any nursing care so we did not assess this regulated activity.

At the time of our inspection there were 137 people who used the service. We spoke with five people and thirteen of their relatives. We spoke with the registered manager, the operational manager and four members of staff. We also looked at four people's care records and five staff records. To help us understand how people's care was delivered we undertook one home visit, this was done with the person's consent and we did not observe any areas of care that would impact on their privacy or dignity.

People's privacy, dignity and independence were respected

The lack of appropriate care plans and risk assessments meant that care was not always planned and delivered in a way that was intended to ensure people's safety and welfare.

Systems in place to ensure that vulnerable people who used the service were safeguarded from the risk of harm and abuse were not robust.

We saw that the provider did not have effective recruitment and selection procedures in place to ensure that only staff suitable to work with vulnerable people were employed.

Gaps and inconsistencies in staff training, appraisals and staff meetings meant that staff may not receive the support that they needed to deliver care safely and effectively.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received. The system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others was not effective.