This inspection took place on 21 and 29 August 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

This service is a domiciliary care agency. It provides personal care to older people living in their own flats within the Pilgrims Court complex.

Not everyone using MHA Care at Home – Wesley Branch receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

On the days of our inspection there were 45 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with CQC to manage the service. Like 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 last inspected the service in December 2015 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

Appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

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.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at the service.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

People were protected from social isolation.

The provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager. People who used the service, family members and staff were regularly consulted about the quality of the service.

This inspection took place on 30 and 31 December 2015 and was unannounced.

We last inspected this service in May 2014. At that inspection we found the service was meeting all the legal requirements in place at the time.

MHA Care At Home Wesley Branch is a domiciliary care agency providing care to older people in their own flats within a sheltered housing complex. It does not provide nursing care. It was providing a personal care service to five people at the time of this inspection.

The service had a registered manager. 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 had been trained in the protection of vulnerable people from abuse, and were knowledgeable about the signs of abuse. They knew how to report any concerns and told us the registered manager responded appropriately to such reports.

Risks to people were regularly assessed and control measures put in place to minimise any risks identified. Accidents were recorded and analysed, to prevent recurrence. Systems were in place to check the safety of the building. Plans were in place to deal with any emergencies.

There were sufficient staff hours available to ensure people’s needs were fully met, in an unhurried way. Staff recruitment processes were robust and professional, and ensured only suitable applicants were employed. The staff team were skilled and experienced and received regular training to meet people’s needs. Staff were supported in their roles by regular supervision and an annual appraisal of their work.

People were assisted to take their medicines by staff who had been appropriately trained, and had their competency checked.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005. These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom.

Appropriate assessments had been undertaken of people’s capacity to make particular decisions. Where people lacked such capacity, appropriate ‘best interest’ decisions had been taken, with the involvement of the person’s family, and these were clearly recorded. People were asked for their consent before staff members carried out any care tasks or other interventions.

People and their families were fully involved in the assessment of their care needs, including their health and nutritional needs. Support to meet those needs was given in the ways the person wished. This was recorded in their care plans, and regularly reviewed. People were encouraged and supported to be as independent as possible in their daily lives.

The staff demonstrated a genuinely caring approach to people, and treated them as individuals. Staff were knowledgeable about people’s likes, dislikes and wishes. Relationships between people and staff were based on mutual respect and affection. People’s privacy and dignity were protected by the staff team.

People were given the information they needed to understand the services available to them and to make informed choices about their daily lives. Advocacy services were available to those people who needed such support. Any concerns or complaints were responded to promptly and professionally.

People were protected from the risks of social isolation and were offered stimulating activities and companionship.

The service was well-managed and had an open, inclusive and listening culture that respected the views of people, their families and staff members. Systems were in place to monitor the quality of the service being provided and there was a commitment to continuous improvement.

MHA Care at Home – Wesley Branch is registered to provide personal care to older people living in their own flats at Pilgrims Court. Pilgrims Court has 41 self contained flats, some of which are suitable for two people. At the time of our inspection there were 45 people living at Pilgrim Court.

Our inspection team was made up of 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. Below is a summary of what we found. The summary is based on observations during the inspection, speaking to people who used the service and the staff supporting people.

Everyone we spoke with told us that they were happy living at Pilgrims Court and spoke positively about the service and care they received from MHA Care at Home – Wesley Branch. We saw that staff had a good rapport with the people using the service.

We saw that individuals were involved in making decisions about all areas of their care. People told us that they had talked about their end of life wishes, as well as their personal and care needs and they had been supported by staff to document everything in a care plan.

We noted that the people at Pilgrims Court organised a lot of communal activities and this was important to people who used the service. People told us they felt like a family unit and that the registered manager and staff supported them to organise events.

People told us and we saw that there was sufficient staff on duty at all times.

At the time of our inspection there was a registered manager in place. We saw that the service had a positive culture and that there was a strong element of support and clear leadership. We were confident that all members of staff were aware of their roles and responsibilities and were supported in their roles.

This was an inspection to follow up on concerns about record keeping identified at the last inspection. These concerns included the quality of people's care and treatment records; how complaints were recorded and responded to; how feedback from quality assurance surveys was held; and how information about the service made available to people using the service and their representatives was kept up to date.

We looked again at these areas on this inspection. We found significant improvement in all the areas previously identified as being of concern. People's care records had been reviewed and updated. Complaints and other forms of feedback were recorded in good detail. Information from surveys was now held in the service and acted upon. Information about the service had been updated.

People who were receiving a personal care service at Pilgrims Court told us they were very happy with the quality of their care. People’s comments included, “The care is absolutely marvellous”, and, “I have nothing but good to say about the service.”

People told us that they were always treated with respect and said that staff always asked their permission before carrying out any care or other tasks for them.

Appropriate systems were in place to make sure staff recognised the signs of abuse of vulnerable people and reported any suspicions promptly. We saw from documentation that this worked in practice.

People receiving personal care were protected by the robust recruitment and selection processes in place to prevent unsuitable people from being employed.

Systems were in place for gaining the views of people who used the service, and of staff, about the quality of the service offered. People told us they felt listened to and treated with respect. Staff expressed similar feelings.

Some care and other records kept in the home were not sufficiently detailed to reflect the quality of the care given, and there were some problems with the accessibility of records. There was no system for recording complaints.