About the service:

M & S Care Solutions - English Walls is a domiciliary care agency, providing personal care to people in their own homes. The service operates from the registered address based in Oswestry. At the time of this inspection six people were using the service.

People’s experience of using this service:

Safe Care and Treatment was not always consistently provided. People’s level of risk was assessed from the outset but risks were not always regularly reviewed or assessed.

Medication processes were not safely in place. People received support with their medicines from staff who had received medication training however, their competency levels were not routinely assessed.

Medication care plans did not contain the appropriate level of information in relation to ‘as and when’ needed (PRN) medication and medication audits were not effectively identifying errors.

Although people told us they received continuity of care from regular members of staff, punctuality of staff was an issue. People were not receiving support visits at their allocated times.

Safeguarding and whistleblowing procedures were in place. Staff told us how and why they would report their concerns as a measure of keeping people safe and protected from harm. However, not all staff had completed safeguarding training.

Staff were not receiving regular supervision or being supported with the correct level of training that was required. Training was not up to date and expired training had not been refreshed. Staff were not receiving regular supervision

The registered provider was not complying with the principles of the Mental Capacity Act (MCA) 2005. People’s capacity was not appropriately assessed and best interest meetings/decisions were not taking place.

Quality assurance processes were not always effectively in place. Audit tools and checks were not always identifying areas of improvement that needed to take place.

People also had the opportunity to share their thoughts, opinions and suggestions and the provision of care they received. However, it was not always clear how areas of development were being addressed.

Recruitment processes were in place however pre-employment checks need to be further strengthened.

People told us that staff provided care that was kind, compassionate and considerate. One person told us, “The care is excellent, I can’t fault it.”

People’s privacy, dignity and independence was promoted. Positive relationships had developed between people receiving support and care staff.

An activities co-ordinator had been recruited specifically to support people with hobbies, interests and those who were socially isolated. People were being supported to complete ‘Life Story’ booklets; ‘life story’ information provided staff with essential details about people’s likes, dislikes, wishes and preferences.

The registered provider had a complaints policy in place. Information about the complaints process was provided to people from the outset; people and relatives told us they would feel confident raising their concerns.

Rating at last inspection: This was the first inspection since the registered provider had registered with The Care Quality Commission (CQC) in November 2017.

Why we inspected: This was a planned comprehensive inspection as part of CQC’s inspection schedule.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Please see ‘what action we told provider to take’ section at the end of report.