Cera - Norwich

Inspection site activity commenced on 17 January 2019. At the time of inspecting 221 people were receiving a regulated activity. Not everyone using Mears Care (Norwich) receives a regulated activity; CQC only inspects the service being provided by people with 'personal care; help with tasks related to personal hygiene and eating.

The service had a registered manager in place. They were present throughout the 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.

At our last inspection we rated the service 'Requires Improvement'. At that inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We were concerned that the systems in place around monitoring the administration of medicines were not fully effective, and we could not be assured they were always managed safely. We were also concerned at our last inspection that there were no systems in place to check that the content of people's care plans was relevant with enough individualised guidance for staff to follow. We also had found that people's visit times were not always carried out at the agreed times and for the agreed length of time. People's preferences were also not always being met and care records did not always contain sufficient guidance for staff with regards to people's individual risks around specific health conditions or behaviours. People's mental capacity was not assessed for specific decisions, and there were no records of best interest's decisions for those people who did not have full capacity. People knew how to complain; however, some people did not feel comfortable to do so.

At this inspection we found that improvements had been made and that the service was no longer in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered manager and staff team had taken on board the feedback we had provided and had worked hard to make the necessary changes. Between our inspection on 17 June 2017 and the current inspection commenced on 17 January 2019 the registered manager and substantially reduced the number of people they were providing a personal care service to in order to work on improvements and embed new practices. At this inspection we have rated the service 'Good' overall.

People felt safe with the service they received and were confident with the knowledge and skills of the care staff that supported them. Staff were well trained and had observations of their practice carried out at frequent intervals. Staff knew what abuse and harm was and they were also aware of how to report any concerns if they had them. People were positive that they consistently received their care calls however

these were on occasion late resulting in two people telling us they had been unable to have their meal at their planned time. People couldn't always have their care at their choice of time.

Staff managed people's medicines in a safe way and were trained in the safe administration of medicines. Staff understood the need to protect people from the spread of infections. People were supported to maintain good health. Staff responded appropriately if people's health deteriorated or they felt unwell and staff made sure they contacted the appropriate professionals to ensure people received effective treatment.

People felt that staff treated them with kindness and were caring in their approach to supporting people. People had their privacy and dignity respected by staff. Feedback from people and relatives indicated that positive relationships had developed between people and care support staff.

There were effective systems in place to monitor the quality of care and support that people received. The provider had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained. Plans were in place and been commenced to update the care planning system to a new electronic format.

Systems were in place to obtain feedback from people about the quality of the service they received through satisfaction surveys and frequent review meetings. Audits had been carried out in relation to care documentation, staff files and medicines. The aim of this audit was to look at the overall running of the service. Feedback from people and their relatives was welcomed. People and their relatives knew who to contact if they needed to raise a concern or a complaint. There were opportunities for people to provide their feedback about the service they received.

The five questions we ask about services and what we found