About the service:

Master Quality Healthcare Services Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. The service was providing personal care to 16 people in the Leeds, Wakefield and Trafford areas at the time of the inspection. Master Quality Healthcare Services Ltd provides a service to younger and older adults.

People’s experience of using this service:

¿ People spoke positively about the service and were happy with the care provided. One person told us, “I can’t fault them [care staff] one little bit. They treat me as though I’m their mum, you can’t get no better care than that.” Another person said, “The carers are excellent.” One relative told us, “This agency does everything that you’d hope for, in a kind and caring way.”

¿ We found risks to the health and safety of service users were not always fully assessed and the provider was not taking reasonable steps to lessen such risks. People did not have risk assessments in place for catheter care, choking and pressure ulcers.

¿ We found medicines were not always managed safely. There was no allergy information recorded on the Medication Administration Records, there was no information to guide staff on what medicines were being taken, any side effects of the medicines and people's preferences for taking their medicines.

¿ We concluded the above demonstrated a breach of regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014, safe care and treatment.

¿ We checked whether the service was working within the principles of the MCA. We found conflicting and unclear information regarding people’s capacity to make decisions. We concluded this demonstrated a breach of regulation 11 of the Health and Social Care Act (Regulated Activities) Regulations 2014, need for consent.

¿ At the last inspection it was noted there was a limited level of detail within the care plans regarding a person’s background and preferences. At this inspection we found this continued to be the case. There was no information within people’s care records regarding their end of life wishes in relation to their care and support. At the time of inspection no one was receiving end of life care. The provider told us this was because no one was currently receiving end of life care.

¿ There were insufficient systems and processes in place to assess, monitor and improve the quality of the service. Quality audits did not adequately identify areas in need of improvement. The provider did not assess, monitor or mitigate the risks relating to the health, safety and welfare of the service users. The provider had not assessed people’s risks in relation to pressure care, choking or catheter care. We concluded these issues demonstrated a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, good governance.

¿ The provider had submitted notifications to the CQC, however we identified instances where matters had not been notified to us as required by regulation. This is a breach of regulation 18 of the CQC (Registration) Regulations 2009.This will be dealt with outside this inspection process.

¿ The provider was considering moving staff supervisions from six monthly to once a year. We made a recommendation that the provider holds supervisions every three months in accordance with best practice guidance.

¿ Complaints were responded to, they identified any issues, actions taken and future learning. However, the provider did not keep an overview to identify any patterns and trends.

¿ The staff we spoke with were complimentary about the management team. Team meetings were held to discuss any issues. The minutes showed the registered manager had a focus on staff well-being and had organised a well-being workshop.

¿ We saw examples of staff promoting people’s independence. One relative told us staff respected their family member and their wishes. They told us they were respectful of their home and

The inspection took place on 11 May 2016 and was announced. The service had been registered with the Care Quality Commission since July 2015 and this was the first inspection of the service.

Master Quality Healthcare Services Limited provides domiciliary care services to people in their own homes. The people who receive these services have a wide range of needs. At the time of the inspection, the service provided care and support to eight people.

The service had a registered manager in post at the time of our inspection. 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.

People told us they felt safe and staff had received safeguarding training in order to keep people safe. There were enough staff to meet people’s needs with a regular, small staff team and there were robust recruitment practices in place, which meant staff had been recruited safely. Risks to people and staff had been assessed and were minimised where possible.

Staff told us they felt supported and we saw staff had received induction and training. Staff received appropriate supervision and their competency was regularly assessed.

We saw from the care files we reviewed the registered manager sought and obtained consent from people, prior to their care and support being provided.

People and relatives we spoke with told us staff were caring. People’s privacy and dignity were respected. The staff we spoke with were enthusiastic and were driven to provide good quality care.

Care and support plans were personalised and these were reviewed regularly. People were offered choices. Appropriate referrals for additional support for people were made when necessary.

The registered manager was not fully aware of their responsibilities to report specific incidents to the Care Quality Commission.

Regular quality assurance audits took place and the registered manager took action to improve the quality of service provision. People told us they felt the service was well led. The registered manager encouraged a culture of transparency.