Archived: MCMH Cornwall

Updated 29 May 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service is required to have a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of the inspection there was no registered manager in post. The manager told us they were in the process of applying for registration.

Notice of inspection

We gave the service notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 11 May 2021 and ended on 12 May 2021. We visited the office location on 11 May 2021.

What we did before inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We met the manager and nominated individual at the service office. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with eight people who used the service and seven relatives.

We reviewed a range of records. This included two people’s care records, four staff files, staff rotas, incident reports and staff meeting minutes. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with seven members of staff and a professional who has experience of working with the service.

Updated 29 May 2021

About the service

MCMH Cornwall is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection 21 people were using the service. 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. 19 people were receiving support with personal care.

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

Staffing levels were low as some staff had left to return to jobs they had held prior to the pandemic. Remaining staff were working longer than their agreed hours in order to cover all visits. Some reported feeling ‘stretched’ but wanted to make sure people received their care as planned.

Some new staff had been recruited which would alleviate the situation. However, they needed to complete an induction and a period of shadowing before they were able to start working independently.

We identified an incident which should have resulted in a safeguarding referral being raised with the local authority and a notification. This had not been completed.

Audits and checks of the service had failed to identify foreseeable risks. Due to the low staff numbers the manager and co-ordinator were working in the community delivering care and spending less time in the office. This was beginning to have an effect on the record keeping and documentation.

Risk assessments were in place for risks such as falls and poor nutrition. These had not been developed for situations when people were distressed, and their behaviour could be unpredictable. We have made a recommendation about this in the report.

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.

People were complimentary about the staff team. They told us they were treated with dignity and staff were friendly and caring. They were confident their confidential information was respected.

Care plans were in place for everyone using the service. There were plans to invest in an electronic system which would support more effective monitoring and recording.

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 25/04/2019 and this is the first inspection.

Why we inspected

This was a planned inspection.

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 monitor the service.

We have identified breaches in relation to staffing levels, safeguarding and oversight of the service. Please see the action we have told the provider to take at the end of this report.

Follow up

We have requested weekly reports to enable us to monitor staffing levels. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. 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.