12 February 2015
During a routine inspection
We carried out this inspection of Medacs Healthcare - Manchester over two days on 11 and 12 February 2015. On the first day we contacted people using the service by telephone and on the second day we visited the offices. We gave 48 hours’ notice of the inspection.
The previous inspection took place on 23 January 2014 when we looked at specific areas relating to information we had received. The inspection before that had been in April 2013. On both these inspections we found the service was meeting legal requirements.
Medacs is a domiciliary care agency providing personal care and other services to people in their own homes. The service covers the local authority areas of Manchester City and Trafford. At the date of our inspection the service was providing care to approximately 400 clients in the two 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 (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.
We found that most people felt safe with the service provided by Medacs. However some people told us they were unsettled by frequent changes in staff, and by late visits. There had also been a continuing small number of missed visits reported to us by the service. We considered the service needed improvement in this area.
Medacs operated safe recruitment practices and staff were trained in safeguarding.
There was a dedicated trainer employed both to train new recruits and to organise ongoing training for staff. Supervisions took place but there was scope for more annual appraisals to support staff. The registered manager and other staff understood the principles of the Mental Capacity Act 2005 and how to apply it.
People told us that their care workers were caring and respected their dignity and maintained their independence. However, several people told us about aspects of their care which were less satisfactory, which indicated that the service required to improve in this area.
Medacs had a detailed complaints procedure which was available for all clients. We saw evidence that it was usually effective. However, one person reported dissatisfaction with the complaints process. Not all complaints had been dealt with inside the deadline. Most complaints related to late or missed visits, which the registered manager was working to reduce.
People told us that the care workers used the care plans but also actively discussed with them the care they were giving. People had been involved when their care plan was created but were less sure whether they had been involved in reviews.
Most people told us they were pleased with the management of the service. The registered manager was attempting to deal with the problem of high turnover of staff. However, people using the service told us that the response they received from office staff was often poor. A professional working in the community reported similar issues to us. The number of spot checks conducted was low compared with the staff numbers. These areas meant that the service still required improvement, although we acknowledged that progress was being made in these areas.
We saw there was good management structure although new care co-ordinators were needed. Disciplinary issues were handled effectively. Medacs had acquired a good reputation with local authorities for the provision of a reliable service.