The inspection took place on 16 February 2017 and was announced. The provider was given 48 hours’ notice of the inspection. This was because the location provides a domiciliary care service. We needed to be sure that the registered manager would be available to speak with us.

Medacs Healthcare-Leicester provides personal care to adults with a variety of needs living in their own homes. This included older people, people with a sensory impairment, people with physical disabilities, people living with dementia and younger adults. At the time of the inspection there were 140 people using the service. On 7 November 2016 Medacs Healthcare – Leicester started to provide care packages to people who had previously received care from other care providers as part of a new contract. This meant that they had a large number of care calls in one geographic area where they had not worked prior to this date. As part of this process Medacs Healthcare – Leicester transferred staff from other providers to be employed by them. Since this date we had an increased number of concerns about the service raised directly with us. This prompted the inspection to be brought forwards.

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.

People were protected from the risk of harm at the service because staff had undertaken training to recognise and respond to safeguarding concerns. They had a good understanding about what safeguarding meant and how to report it. The provider dealt with accidents and incidents appropriately and reviewed these to try and prevent reoccurrences. Risks to people’s well-being had been assessed.

We found there were enough staff to support people safely during our visit. However, we found that in November when the provider had started to support people in a new geographic area there had been times when people had not had all of their care calls. People told us that had improved. Staff had been checked for their suitability before starting work.

People’s medicines were handled safely and were given to them in accordance with their prescriptions. The provider agreed to make sure that all medicines that were to be given were written down individually. We found that guidance for staff when to give medicines that were as and when required was not in place. The registered manager agreed that this would be developed.

Staff received appropriate support through an induction and regular supervision. There was an on-going training programme to provide and update staff on safe ways of working.

People chose their own food and drink and were supported to follow a specific diet if this was required. Staff prompted people to contact healthcare services when required to promote their well-being.

People were asked for their consent before they were supported. People were encouraged to make decisions about their care.

People felt that they did not always receive care from the same staff team. Staff told us that they were beginning to work more regularly with the same people to improve this.

People received support from staff who usually showed kindness and compassion. Their dignity and privacy was protected.

People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives. Some people felt that their complaints were not always responded to.

People felt that staff were sometimes late and they were not always contacted about this when it happened. Some people felt rushed while they were receiving support.

People and their relatives had contributed to the planning and review of their support. People had care plans that included information about

The inspection took place on 14 January 2016 and was announced. The provider was given 48 hours’ notice of the inspection because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available to speak with.

The service provided personal care to adults with a variety of needs living in their own homes. This included people living with dementia, physical disabilities, older people, people with learning disabilities and younger adults. At the time of our inspection there were approximately 60 people using the service who received support that included regulated activities.

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.

People told us that they felt safe when staff supported them.

When people started to use the service a care plan was developed that included information about their support needs, likes, dislikes, history and preferences. This meant that staff had the relevant information to meet people’s needs.

Risk assessments were in place which set out how to support people in a safe manner. The service had safeguarding and whistleblowing procedures in place. Staff were aware of their responsibilities in these areas.

People told us that staff arrived on time for appointments to support them. We saw that records showed that stayed for the time they were supposed to.

People were supported to take their medicines by care workers who had received training in medicines management.

Care workers were supported through training and supervision to be able to meet the cares needs of people they supported. They undertook an induction programme when they started to work at the service.

Staff told us that they sought people’s consent prior to providing their care. Where people were believed to not have the capacity to make specific decisions the service followed the correct procedures in line with the Mental Capacity Act 2005.

Staff developed caring relationships with people and understood people’s needs and preferences.

People were involved in decisions about their support. They told us that staff treated them with respect.

People and staff felt the manager was approachable and would listen to them.

Questionnaires were carried out with people who used the service to monitor the quality of the service. People were not given feedback to tell them what would change as a result of the questionnaire.

The provider carried out monitoring of the quality of the service. Actions plans were developed however progress against these was not monitored.

The people who used the service and their relatives told us the agency provided good care. One person said, “The service is fantastic. All the staff are skilled and they don’t make mistakes and I’ve never had to pull anyone up for anything.” Another commented, “The staff are funny they make me laugh. I was shy at first but once I got to know them I was fine. I get on well with my carer because we both like the same music.”

People said they felt safe using the agency and trusted the carers. They also knew what to do if they had a complaint. One person told us, “If I wasn’t happy about anything I’d ring my care co-coordinator and arrange to meet with her to discuss it.” Another person commented, “My care co-ordinator is amazing. If there’s a problem or issue she sorts it out straight away.”

People told us they were pleased with the staff the agency supplied. One person said, “The staff are brilliant and very accommodating. They have become part of our family.” Another person commented, “The agency does its best to give me regular carers and they are always nice and respectful.”

People said they were regularly asked to comment on their care. One person said, “Medacs staff phone up or come and see us. They want to know if we’re happy with the staff and that everything’s alright.” Another person commented, “We get an annual survey which you can fill in to rate the agency.”

People said the care the agency provided was good. One person told us, “I am satisfied in every way with Medacs. The care is excellent.” A relative commented, “The agency provides fantastic care – I can’t praise them enough – they deserve five gold stars.”

People told us they felt safe using the agency and trusted the carers. They also knew what to do if they had a complaint. One person said, “If I had a complaint I would contact Medacs and discuss it with them.” A relative told us, “If I had a problem with the service I would tell the carers as I know them well.”

People said they liked the staff team and tended to have the same carers. One person told us, “I have no problems with the staff. They are very rarely late and always pleasant and helpful.” Another person commented, “I usually get the same people which is good because I don’t have to keep explaining to new people what I need.”

People told us the agency contacted them regularly to get their views on the service. One person said, “Medacs phone or email me every few weeks to see how I’m getting on and if I’m happy with the care.” A relative commented, “Medacs staff are always ringing me and coming round to make sure everything’s alright. They are brilliant.”