Archived: MiHomecare - Hersham

Updated 15 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 July 2016. The provider was given 48 hours’ notice of our visit because we wanted to ensure the manager was available to support the inspection. One inspector carried out the inspection.

Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. We also reviewed the Provider Information Return (PIR) submitted by the provider in June 2016. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we visited the agency’s premises and spoke with the manager, the regional manager and the provider’s quality and performance manager. We checked care records for five people, including their assessments, care plans and risk assessments. We checked five staff recruitment files and other records relating to the management of the service, including staff training and induction, the complaints log and quality monitoring checks.

After the inspection we spoke with 16 people that used the service and five of their relatives by telephone to hear their views about the care and support provided. We spoke with eight care workers about the support and training they received to do their jobs and a field care supervisor.

This was the first inspection of the service since its registration with the CQC.

Updated 15 February 2017

The inspection took place on 15 July 2016 and was announced.

MiHomecare - Hersham provides care and support to people in their own homes. The majority of people who use the service are older people, some of whom are living with dementia. The service provided care and support to 164 people at the time of our inspection.

There was no 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 and associated Regulations about how the service is run. A new manager had taken up their post shortly prior to our visit. The manager told us they would apply for registration with the CQC.

People who were supported by regular staff were satisfied with the care they received. They trusted their care workers and had confidence in their ability to provide the care they needed. Some people said the quality of care was affected when their regular care workers were unavailable and they were visited by replacement care workers. They told us this was because some replacement care workers had not been given enough information about their needs before they visited them.

People told us they felt safe when staff provided their care. They said their care workers made sure they were comfortable when delivering care and support. People and their relatives told us that care workers maintained the security of their homes when they visited. Risk assessments had been carried out to protect people receiving care and the staff supporting them. There were plans in place to ensure that people would continue to receive care in the event of an emergency.

The provider’s recruitment procedures helped ensure they employed only suitable staff. Staff had received training in safeguarding and knew how to recognise the signs of abuse. People and their relatives told us staff helped them take their medicines safely. People told us that their care workers took appropriate action if they felt unwell.

People’s rights were protected because their care was provided in accordance with the Mental Capacity Act 2005 (MCA). People told us they had been asked to record their consent to the care they received and that staff always obtained their permission before providing their care. The manager understood the principles of the MCA and ensured that people who may lack capacity received support to make decisions about their care.

People told us their care workers were kind and caring. Relatives said their family members regular care workers knew how they preferred their care to be provided. People told us they were treated with dignity and respect. They said their care workers listened to what they had to say and respected their wishes. Relatives told us their family members’ care workers supported them to be as independent as possible and maintained their dignity when providing their care.

People’s needs had been assessed before they began to use the service. An individual care plan was developed for each person following their assessment. People told us their care plans reflected their individual needs and that their regular care workers were willing to be flexible in the support they provided. Staff told us they had the time they needed to provide people’s care at each visit.

The provider had appropriate procedures for managing complaints. Most people had not needed to complain. Some people who had complained in the past were not satisfied with the agency’s response. The new manager was aware of some people’s dissatisfaction the response to their complaints and had taken steps to encourage people who used the service and their relatives to give feedback about the service they received. The new manager advised that the management of complaints would be assessed regularly as part of the provider’s quality assurance systems.

Some aspects of the service had not been well-managed in the past. People had not received a consistent service and staff had not been well supported. Quality monitoring systems had not been effective in identifying areas for improvement. With support from the provider’s regional manager and quality and performance manager, the new manager had put plans in place to address these concerns. The new manager had improved the communication with people who used the service, their relatives and other stakeholders. Quality monitoring reports had been introduced and shared with the local authority. The support provided to staff had improved with the introduction of regular management supervision.