We carried out a review of the data available to us about Medacs Healthcare Greater Manchester on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Medacs Healthcare Greater Manchester, you can give feedback on this service.
Medacs Healthcare Old Trafford (Medacs) is a large domiciliary care agency providing personal care to people in their own homes. It provides a service to adults and to children of all ages in Manchester and Trafford. Medacs is also a provider for Trafford Council's Stabilise and Make Safe (SAMS) and Rapid Response projects. SAMS is a three-week service to assess and report on people’s support needs and Rapid Response is a short-term three day service. At the time of our inspection the service was providing care and support to 364 people, making over 7000 care calls each week.
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
People and relatives said they felt safe and were supported by well trained and caring staff. Assessments and care plans were in place for the support people needed. Risks had been assessed and plans were in place to manage these known risks. People received their medicines as prescribed.
Staff were positive about working for the service. They felt well supported by the management team and all training was up to date. Staff were safely recruited and completed a robust induction programme before starting to support people. Staff knew how to report concerns. The local authority said improvements had been made in reporting and escalating concerns to them.
The registered manager had a range of reports to monitor the service, for example call times. Monthly audits were completed for medicines and daily records. All incidents and complaints were investigated and actions taken to reduce the risk of a re-occurrence. Changes were being made to ensure the management team had the capacity to make spot checks with staff and monitoring calls with people or relatives at the required times.
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; the policies and systems in the service supported this practice.
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 4 June 2018).
Why we inspected
This was a planned inspection based on the previous rating. We had also received concerns about the communication and escalation of changes in people’s needs to the local authority in a timely manner. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and well-led only.
We found no evidence during this inspection that people were at risk of harm from this concern. Steps had been taken to ensure any changes in people’s needs were communicated to the management teams and escalated as required. Please see the Safe, Effective and Well-led sections of this full report.
We reviewed the information we held about the service. 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 remained good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Medacs Healthcare Old Trafford on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Medacs Healthcare Old Trafford (Medacs) is a domiciliary care agency providing personal care to people in their own homes. It provides a service to adults and to children of all ages.
Medacs is also a provider for Trafford Council’s Stabilise and Make Safe (SAMS) project which is a short term service. As part of the SAMS project, Medacs provide a three night service whereby care staff, who are trained on completing risk assessments, undertake an assessment of a persons’ care needs. At the end of the three nights support and assessment they provide information to the council social work team about their assessment of the care the person requires.
On the date of our inspection the service was providing care and support to approximately 371 people in three local authority areas.
The service had a registered manager who was present during the inspection. 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.
During the last inspection of Medacs Healthcare Old Trafford in March 2017 we found there were three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to; care plans not always meeting the needs of the people who used the service, the provider not doing all that was practicable to reduce the risks caused by missed visits to people who used the service and the provider not adequately assessing, monitoring and mitigating the risks to the health, safety and welfare of people because of the missed visits.
Following the last inspection of March 2017 we asked the provider to take action to make improvements. The provider sent us an action plan informing us that they had taken action to ensure the Regulations had been met. During this inspection we found the provider had complied with the previously breached Regulations.
Systems had been put into place to monitor and reduce the number of missed visits to people who used the service.
People's care records contained enough information to guide staff on the care and support required. The care records showed that risks to people's health and well-being had been identified and plans were in place to help reduce or eliminate the risk. Assessments were also undertaken around risks associated with general safety issues within people's homes.
We found that suitable arrangements were in place to help safeguard people from abuse. Guidance and training was provided for staff on identifying and responding to the signs and allegations of abuse.
We found people were supported by sufficient numbers of suitably skilled and experienced staff who received a thorough induction, were adequately supervised and were safely recruited.
People we spoke with told us the staff were kind and reliable and had the right attitude, skills and experience to meet their needs.
We saw that staff were taught to deliver non-discriminatory practice and cultural awareness to ensure that people’s cultural and religious beliefs were respected.
Staff received the essential training and support necessary to enable them to do their job effectively and support people safely. Records showed that staff had also received training relevant to their role.
Records showed that reviews of people's care were undertaken regularly.
We found the medicine management system was safe. Records showed that staff received training and competency assessments before they were permitted to administer medicines.
We found that the service was working within the principles of the Mental Capacity Act (MCA) 2005 and that staff had a good understanding of the MCA.
People told us they knew how to make a complaint. Records we looked at showed there was a system in place for recording complaints and any action taken to remedy the concerns raised.
Effective systems for monitoring the quality of the service were in place. Records showed that audits were undertaken on all aspects of the running of the service. There were also opportunities for people who used the service to comment on the care and support provided.
The previous inspection of this service was in February 2015 when it had another name, Medacs Healthcare Manchester, although it had just moved to its new offices in Old Trafford. At that inspection we found the service to be ‘requires improvement’ in four areas and overall. We found no breaches of regulations.
Medacs Healthcare Old Trafford (Medacs) is a domiciliary care agency providing personal care and other services to people in their own homes and in one extra care facility. The service covers primarily the local authority areas of Manchester City, Trafford and Tameside. At the date of our inspection the service was providing care to approximately 550 clients in the three local authority areas.
There was a registered manager in post who had taken up her position in June 2014. 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 receiving the service told us they felt safe when the care workers visited. They were however unsettled by late visits and missed visits, by visits being cut short and by unfamiliar care workers arriving.
Missed visits had been a historical problem with this branch of Medacs. The list of missed visits showed over 100 missed visits in a year, but we came across further missed visits which were not on this list. Consequences of missed visits could be very serious, although they were a small proportion of overall visits made.
Action was being taken. The causes of missed visits were analysed and disciplinary action taken when needed. One potential cause was a care worker receiving more than one call on their rota at the same time. We were assured this would no longer happen once a new mobile phone system was introduced.
We considered that the level of missed visits was unacceptable and was a breach of the regulation relating to the safety and welfare of people using the service.
Recruitment procedures were robust. Staff were trained in safeguarding and knew how to report abuse and whistleblow if necessary.
Staff were also trained in administering medication. We considered that the care plan should specify what medicines people were receiving to reduce the possibility of errors.
People using the service thought their care workers were well trained, on the whole. All new staff did a three day induction followed up by the Care Certificate. There was ongoing refresher training for all staff, and specialist courses were available.
Staff received regular supervision and were often observed by their supervisor while delivering care. Not everyone had received an annual appraisal.
The service was aware of the requirements of the Mental Capacity Act 2005 (MCA). The policy on consent was clear, but the form used to record consent if a person lacked capacity to consent did not make clear that a family member alone cannot give consent in those circumstances.
Staff supported people to access healthcare services. Where it was required, staff prepared food for people using the service which was generally liked.
People gave us positive feedback about the care they received. They particularly valued their regular care workers. We found evidence that carers were sympathetic to people’s needs. People thought that care workers respected their dignity.
Care files and personal data were kept securely in the office. Staff were mindful of treating people equally.
Care plans were created using the support plan provided by the local authority. In some cases there was not enough detail to equip staff to deliver person-centred care. In other cases there was a lack of information in the care plan to tell staff how to deliver care safely. This was a breach of the regulation relating to care plans meeting the needs of people using the service.
People and relatives had been involved in writing and reviewing their care plans.
Some people were unhappy about the response to their complaints, but others were very happy and said their issues had been resolved. Records showed that all formal complaints had been dealt with inside four weeks. Complaints were being analysed to identify any common themes.
Medacs were discussing providing activities in the extra care block of flats where they were now providing personal care throughout the day and night.
Medacs conducted surveys of people using the service and also ran a “Healthcare Heroes” scheme inviting good feedback on care workers.
Some people commended their care workers but criticised what they thought was a lack of response from the office. Staff gave a mixture of views about what it was like to work for Medacs.
There was a high staff turnover and a constant recruitment campaign.
There was a good structure of support for the registered manager both within the office and from Medacs senior management.
There was regular monitoring of care workers. There were audits of staff files. There had been an audit of care files but with a limited remit.
We considered that the level of missed visits, although reported on in our earlier reports, had not been identified by the provider as a serious enough issue. Although steps were now planned to attempt to reduce the number, the fact that so many had occurred represented a breach of the regulation relating to monitoring the quality of the service.
We found breaches of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the end of the full version of the report.