MidCo Care

This announced inspection was carried out on 22 and 26 February 2018. At our inspection in December 2016 the service was rated as Requires Improvement. At this inspection in February 2018 it had improved to Good. At the time of our inspection there were 10 people using the service.

There was a registered manager who had been in post since the service was registered in March 2015. 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.

Staff understood how to recognise and report any suspicions of poor care and harm. Staff were only offered employment at the service, once all necessary checks had been found to be satisfactory. There was a sufficient number of suitably trained staff to provide people with safe care and support.

Staff cared for people in a kind and considerate way and people’s care was undertaken in an unhurried and patient manner. Staff listened to people and assisted them in a caring way. Staff encouraged people to make their own choices and live as independently as possible. People’s privacy and dignity was promoted by staff.

People helped determine what their care arrangements were and the provider took account of people’s wishes and choices and any future goals. People’s care and support plans were an individual record about each person’s needs and any assistance they required from staff. Risks to people were identified, and plans were put into place to promote people’s safety without limiting people’s right to choose what they wanted.

People were 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 supported this practice.

Staff benefitted from the support, training and mentoring they were provided and this helped to promote people’s safety and wellbeing. Staff understood their roles and responsibilities in meeting people’s needs. Systems, including regular spot checks and training were in place to help staff to maintain their skills and the standard of work expected from them by the registered manager.

People were supported to maintain their health by staff that had been deemed competent to safely administer people their prescribed medicines. Staff assisted people to maintain the correct level of nutritional intake of food and fluids. Staff enabled or supported people to access community health care services.

People received a service that helped them to have their needs met in a person centred way. People were encouraged to maintain contact with their relatives and friends when they wished to do so. There was a process in place to manage any concerns, suggestions and complaints. Complaints were resolved to the complainant’s satisfaction.

Staff had various opportunities including meetings to feedback their experiences and receive updates about the service. Any suggestions or concerns that staff had could be raised at one to one supervision meetings or at other occasions staff contacted the office. Staff were supported by the registered manager who listened and acted upon any opportunity for improvement.

Arrangements were in place to ensure the quality of the service provided for people was regularly monitored. People who used the service and their relatives were encouraged to share their views and feedback about the quality of the care and support provided and felt listened to. As a result of feedback, actions were taken to drive forward any improvements that were required.

Further information is in the detailed findings below.

This announced inspection took place on 19, 23 and 28 December 2016.

The service had a registered manager in place. However, they were not present during this inspection. There was an acting manager in place to oversee the service during the registered manager’s absence. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Arrangements were in place to make sure that people, where needed, were supported and protected with the safe management of their prescribed medicines. However, detailed guidance for staff on when to administer ‘when required’ medicines were not always in place.

People had care and support plans in situ which recorded their care and support needs at each individual care call as a prompt for staff. Individual risks to people were identified. Plans were put into place to minimise these risks to enable people to live as independent and safe a life as possible.

The registered manager sought feedback about the quality of the service provided from people. They had in place quality monitoring checks to identify areas of improvement needed. However, these checks had not always identified the areas of improvement required found during this inspection.

Recruitment checks were undertaken before new staff were employed to make sure that they were suitable to work with the people they were supporting. However, these checks were not always completed robustly and inconsistencies were found.

We saw that there was a sufficient number of staff available to support people with their care calls.

Staff received training and understood the principles of the Mental Capacity Act 2005 (MCA).

There was an ‘open’ culture within the service. People and their relatives were able to raise any concerns that they might have with staff and the management team. Records showed that these were responded to and resolved where possible.

People were supported to access external health care professionals where needed, and were assisted to maintain their health. Where this support was required, people’s health and nutritional needs were met.

Staff were trained to provide effective care which met people’s individual support and care needs. However, not all training, such as catheter care training, was documented within the provider’s records as having been completed.

Staff were supported by the registered manager to develop their skills and knowledge through supervisions, competency checks, training and further qualifications. However, we found that staff supervisions did not always take place regularly.

Notifications are information on important events that happen at the service that the provider is required to notify us about by law. The registered manager and the acting manager was aware of and provided us with notifications of all of the important events they needed to notify the Care Quality Commission about.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this focused inspection on 28 June 2016 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for MidCo Care on our website at www.cqc.org.uk.

MidCo Care is registered to provide personal care to people who live in their own homes. At the time of this inspection personal care was being provided to 33 people living in the Peterborough and Bedford areas.

There was a registered manager in post at the time of the inspection. 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.

During this inspection on 28 June 2016 we found that the provider had followed their plans which they told us would be completed by 1 April 2016 and legal requirements had been met.

Since the last inspection changes had been made to check that staff followed the policies and procedures for recording medication that had been administered. There were processes in place to audit medication, and these were robust. The provider and senior staff monitored and audited medicines to improve the quality and safety of the service.

Staff had received training in the administration of medication medicine administration had been Further training dates were noted so that all staff had undertaken the appropriate training.

Recruitment processes were now followed, which meant people were safe because only suitable staff were employed to work with people in their own homes.

The provider had ensured that incidents, errors of medication and missed calls were recorded, investigated and reported to the relevant authorities.

A complaints procedure was in place. The staff responded appropriately to people’s concerns or complaints.