MKF Homecare Limited was rated overall Good at this October 2018 inspection, with four of the five key questions rated Good and Well-led rated Requires Improvement. While the service demonstrated safe, caring, and person-centred care, governance shortfalls persisted including inconsistent record-keeping, incomplete training oversight, and absence of formal feedback surveys.
Concerns (4)
moderate
Governance
: “Records audited were not always consistent and did not always identify gaps. For example, records did not always contain dates on which they had been reviewed or dates when changes had occurred.”
moderateRecord keeping: “Records did not always contain dates on which they had been reviewed or dates when changes had occurred. This made it difficult to confirm the frequency or effectiveness of these reviews.”
moderateStaff training: “There was a lack of management oversight and training was not always consistent...it was unclear when refresher training was due and how this was monitored and managed.”
minorLeadership: “The provider and registered manager had not completed any surveys or questionnaires to determine how the service was performing.”
Strengths
· People felt safe and staff demonstrated good understanding of safeguarding procedures and reporting responsibilities.
· Risks to people's health and well-being were assessed and managed appropriately with individual risk assessments in place.
· Safe medicines management with staff training and competency checks at regular intervals.
· Small, consistent staff team with sufficient deployment and adequate travel time between visits.
· Robust recruitment processes including DBS checks and references from previous employers.
Quality-Statement breakdown (15)
safe: Safeguarding systems and staff trainingGood
safe: Risk assessment and managementGood
safe: Staffing levels and recruitmentGood
safe: Medicines managementGood
safe: Infection controlGood
effective: Staff training, induction and supervisionGood
effective: Consent and Mental Capacity Act complianceGood
effective: Support to maintain health and nutritionGood
caring: Kindness, dignity and respectGood
caring: Involvement in care decisionsGood
responsive: Person-centred care planningGood
responsive: Complaints handlingGood
well-led: Quality assurance and audit systemsRequires improvement
well-led: Record keeping and management oversightRequires improvement
MKF Homecare, a small family-run domiciliary care service, was rated Good overall at its first inspection in August 2017, with staff delivering kind, personalised care and people reporting high satisfaction. However, a Requires Improvement rating for well-led reflected insufficient quality assurance systems, inconsistent record keeping, and gaps in staff training including medicines administration and Mental Capacity Act awareness.
Concerns (8)
moderateGovernance: “There were insufficient quality assurance systems in place to monitor the service effectively.”
moderateRecord keeping: “improvements were required in respect of all records including staff recruitment files, training, staff meetings and supervision, reviews of peoples care”
moderateCare planning: “risk assessments were not always personalised or detailed enough to instruct staff how to care for people safely”
moderateMedication management: “staff had not received training during their employment at the service but had previous experience in administering medicines”
moderateStaff training: “only the registered manager had received training in The Mental Capacity Act 2005 (MCA)... Staff were due to have MCA training on 12 September 2017.”
minorSupervision / appraisal: “Staff told us they met regularly to discuss all aspects of the service although the records were not always kept of the discussions.”
minorStaffing levels: “the registered manger told us that this meant they were working full time to deliver care and this meant that other 'management' tasks were often not completed in a timely way”
minorConsent / capacity: “one staff member told us that she had to remind and prompt a person because they had become forgetful. This may have indicated that a mental capacity assessment was required.”
Strengths
· Staff were caring and compassionate, knew people well, and delivered individualised care that respected privacy and dignity.
· Safe and effective recruitment practices were in place including DBS checks for all staff.
· People and relatives gave consistently positive feedback about the service and the registered manager.
· People were involved in care planning and consent was obtained before care was provided.
· A complaints policy was in place and people knew how to raise concerns; the manager was responsive to feedback.
Quality-Statement breakdown (18)
safe: Safeguarding people from abuseGood
safe: Risk assessment and managementRequires improvement
safe: Recruitment practicesGood
safe: Medicines managementRequires improvement
safe: Staffing levelsGood
effective: Staff induction and trainingRequires improvement