Multi - Care Community Services Ltd is a domiciliary care providing the regulated activity of personal care to people living in their own homes.

This inspection was undertaken by one inspector. At the last inspection on 19 March 2015 the service was rated as ‘Good’. At this inspection we found the service remained ‘Good’.

There was a registered manager in post. 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.

People were supported safely as staff were knowledgeable about reporting any incidents of harm. There were a sufficient number of staff employed and recruitment procedures ensured that only suitable staff were employed. Risk assessments were in place and actions were taken to reduce these risks such as assisting people with their medicines and when supporting people when accessing the community. Arrangements were in place to ensure that people were supported and protected with the safe management of their medicines.

The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005. People were supported to have choice and control over their lives as much as possible. Staff supported people in the least restrictive way possible; the policies and procedures in the service supported this practice.

People were supported to access a range of health care professionals and they were provided with opportunities to increase their levels of independence. Health assessments were in place to ensure that people were supported to maintain their health and wellbeing. There were effective links with healthcare professionals.

A staff training and development programme was in place and procedures were in place to review the standard of staff members’ work performance. Staff were supported and trained to do their job.

Staff supported people with their individual nutritional and dietary requirements when required.

People’s privacy and dignity were respected and their care and support was provided in a caring and patient way. A complaints procedure was in place and complaints had been responded to, to the satisfaction of the complainant. People could raise concerns with the management team and staff at any time.

The provider had quality assurance processes and procedures in place to monitor the quality and safety of people’s care. People and their relatives were able to make suggestions in relation to the support and care provided.

An adult social care inspector carried out this this inspection on 30 September 2014. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with nine people who used the agency, three relatives, the manager, provider, three office based staff, five members of care staff and three healthcare professionals who had contact with the agency. We reviewed records relating to the management of the service which included: six care plans, daily records, medication records, staff recruitment and training records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what people who used the agency, their relatives and the staff told us, what we observed and the records we looked at.

Is the service caring?

The agency provided care and support for people living in their own homes. People told us that they received kind and respectful support from care staff and felt able to make choices and changes to their care when necessary. Relatives that we spoke with were positive about the care and support provided to their family member. Care staff told us that they were supported and supervised so that they could provide safe care and support to people. Courtesy calls were made to people using the agency and their relatives to discuss any care and support issues.

Is the service responsive?

We saw that people’s personal care and support needs were assessed and generally met. This also included people’s individual choices and preferences as to how they wanted their care to be provided. People we spoke with told us that they had been able to make changes to their care and support needs. Relatives that we spoke with also confirmed that they had been involved where changes to care had been made. However, it was evident that care plans were not in detail to provide specific guidelines for staff during each care visit..

Is the service safe?

Staff told us that care planning documentation had not always been in sufficient detail to provide them with information so that they could safely provide support to people.

Detailed risk assessments regarding people’s individual needs were not carried out and measures were not in place to minimise any identified hazards. Recruitment procedures were not effective in ensuring that only appropriate people were employed. We did see that the provider was taking appropriate action to ensure that all care workers had received safeguarding training to ensure peoples’ safety. There were arrangements in place to ensure that staff were trained and supervised so that they could safely provide care and support to people.

Is the service effective?

We found that care workers were knowledgeable about people’s individual care and support needs. People who used the agency that we spoke with, and their relatives, confirmed that care staff provided them with good care and support and were keen to address any concerns or issues. The manager confirmed that reviews of care and support were in place to meet people’s changing/ assessed needs.

Is the service well led?

Staff that we spoke with told us that they were generally well supported by the management team so that they could safely provide care and support. People and their relatives that we spoke with told us that they felt they were listened to and that support was consistently and safely provided. However, effective quality assurance systems were not in place to audit the care and services provided. Surveys were due to be carried out to gather opinions from people who used the agency and members of staff. The manager and care staff were in regular contact with people and their relatives to respond to their concerns or queries

Multi-Care Community Services Limited is registered to provide personal care to people who live in their own homes. There were 54 people using the service when we visited. The inspection took place on 19 March 2015 and we gave the provider 48-hours’ notice before we visited. This was to ensure that the registered manager was available to facilitate the inspection.

The last inspection was carried out on 30 September 2014 when we found the provider was not meeting all the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 we assessed against. We found that the provider was not meeting the regulations relating to care and welfare, medicines, staff recruitment and quality assurance.

The provider sent the Care Quality Commission a report setting out the actions they would take to improve the above areas. At our inspection on 19 March 2015 we saw that improvements had been made.

There was a registered manager in post. 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.

Staff were knowledgeable about reporting any abuse. There were a sufficient number of staff and recruitment procedures ensured that only suitable staff were employed. Risk assessments were in place and actions were taken to reduce identified risks. Arrangements were in place to ensure that people were supported and protected with the safe management of medicines.

Not all staff had received training on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). This legislation sets out how to proceed when people do not have capacity and what guidelines must be followed to ensure that peoples freedoms are not restricted.

Staff were supported and trained to do their job. The staff were in contact with a range of health care professionals to ensure that care and support was well coordinated. Risk assessments were in place to ensure that care and support could be safely provided.

People’s privacy and dignity were respected and their care and support was provided in a caring and a patient way.

A complaints procedure was in place and complaints had been responded to, to the satisfaction of the complainant. People felt able to raise concerns with the staff at any time.

The provider had quality assurance processes and procedures in place to monitor the quality and safety of people’s care. People and their relatives were able to make suggestions in relation to the support and care provided.