Head Office Also known as Mercylink Care Services Ltd

Head Office, Mercylink Care Services Ltd is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to adults and children in their own homes. 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.

At the time of the inspection, the service was supporting 7 people with personal care.

People’s experience of using this service

At our previous focused inspection of this service on 3 August 2020, we found concerns with training, risk assessments, pre-employment checks and good governance. We completed a targeted inspection on 22 November 2020 to check on good governance and training and to follow up on warning notices we served in relation to these and found improvements had been made. At this inspection, we found further improvements had been made.

Risks were identified and assessed to ensure people received safe care. Staff were aware of how to safeguard people from abuse. Systems were in place to ensure staff attended calls on time. Systems were in place to prevent and minimise the spread of infections when supporting people. Pre-employment checks had been carried out to ensure staff were suitable to work with vulnerable people. Medicines were being managed safely.

Staff had been trained to undertake their roles effectively. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received care from staff who were caring and had a good relationship with them. People’s privacy and dignity was respected. People were encouraged to be independent and to carry out tasks without support.

People received person-centred care. Care plans had been reviewed regularly to ensure they were accurate. Systems were in place to manage complaints and people’s communication needs were met.

Quality assurance systems were in place to identify shortfalls to ensure there was a culture of continuous improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The previous rating for this service was Requires Improvement (published 18 September 2020) and there were multiple breaches of regulation. We issued warning notices for a breach of Regulation 17 (Good Governance) and Regulation 18 (Staffing). There were also requirement notices issued for Regulation 12 (Safe care and treatment) and Regulation 19 (Fit and proper persons) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

We undertook this comprehensive inspection to check if there were improvements regarding the concerns we identified at the last focused inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This service is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to adults in their own homes. 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.

At the time of our inspection, the service provided personal care to four people.

People’s experience of using this service and what we found

At our last inspection on 3 August 2020, we found training certificates for some staff were not genuine. The provider was not aware of this. This placed people at risk of harm as staff may not have been trained to perform their roles effectively. At this inspection, improvements had been made and we saw evidence that the provider had sourced accredited training providers to deliver training.

At our previous inspection of this service, we found risk assessments were not robust and did not identify risks to people around their health conditions. Robust pre-employment checks had not been carried out when recruiting staff and consent had not been sought from people to provide care and support. The quality assurance systems were not robust to identify these shortfalls, therefore placing people at risk of harm. At this inspection, improvements in these areas had been made and there were more effective quality assurance systems in place, which included auditing care plans and staff files.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The previous rating for this service was requires improvement (published 19 September 2020) and there were multiple breaches of regulation. We issued a warning notice for a breach of Regulation 17 (Good Governance) and Regulation 18 (Staffing). There were also requirement notices issued for Regulation 12 (Safe care and treatment) and Regulation 19 (Fit and proper persons) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We will assess this at the next comprehensive inspection of the service.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, enough improvement had been made and the service was compliant with the warning notice issued.

Why we inspected

We undertook this targeted inspection to check whether the warning notice we previously served had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on warning notices. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

This service is a domiciliary care agency and is based in the London Borough of Barking & Dagenham. The service provides personal care to adults in their own homes. 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.

At the time of our inspection, the service provided personal care to 28 people.

People’s experience of using this service

Sufficient risk assessments were not in place to ensure people received safe care at all times. This included lack of robust risk assessment for blood thinning medicines and infection outbreaks. Medicines were not always managed safely as prescribed creams were not being recorded appropriately.

Pre-employment checks were not robust to ensure staff were suitable to support people safely.

Adequate safeguarding systems were not in place to ensure lessons were learnt following safeguarding concerns to minimise the risk of re-occurrence. We have made a recommendation in this area.

Staff had not been trained to perform their roles effectively. We found some training certificates were not genuine, which meant staff had not received training in mandatory areas to ensure people received safe and effective care.

Consent to care forms had not been completed in full. This meant people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Quality assurance systems were not in place to identify shortfalls and take prompt action to ensure people always received safe care.

People and relatives told us staff were punctual and systems were in place to monitor time keeping. However, there were discrepancies with times staff visited people, which had not been communicated to the office by staff members.

Systems were in place to obtain feedback from people and relatives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

We carried out an inspection on 2 July 2019 and 3 July 2019. The service was rated Good (published 23 July 2019).

Why we inspected

We received concerns in relation to care being delivered to people by a local authority. As a result, we undertook a focused inspection to review the key questions of safe and well-led only and a targeted inspection on effective.

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 changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Head Office on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risk assessments, pre-employment checks, training and good governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Head Office is a domiciliary care agency that provides personal care to people living in their own homes. At the time of our inspection the service was supporting 13 people.

People’s experience of using this service and what we found

Systems were in place to keep people safe from harm and risk assessments were designed to keep people and staff safe. Recruitment practices were safe, and people received consistent care in a timely manner.

There were systems in place to make sure people received their medicines safely. The service analysed accidents and incidents to prevent reoccurrence and keep people safe from harm.

Staff were supported through training and supervisions to provide effective care and support. People were supported to have their nutritional needs met and there was guidance in care records as to

how to meet these. The service worked well with other health and social care professionals to provide holistic care and support and keep people well. People were supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did support this practice.

People and relatives told us they found staff were kind and caring and staff respected equality and diversity. People felt they were treated with dignity and were encouraged to be as independent as possible.

People received individualised care that met their needs. We have made a recommendation that care plans were reviewed to reflect protected characteristics. Information was provided to people in an accessible format. People told us they felt able to make a complaint and were confident that complaints would be listened to and acted on. Staff were equipped with the skills to provide end of life care to people.

People, relatives and staff spoke positively about the service and said it was managed well. There were

systems in place to manage and monitor the quality of the service provided. The management team had regular contact with people using the service and their staff. They welcomed suggestions on how they could develop the services and make improvements. The registered manager kept up to date with best practice to ensure a high-quality service was being delivered.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 06/07/2018 and this is the first inspection.

Why we inspected

This was a planned inspection based on our inspection schedule.

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.