Archived: MiHomecare - Seaford

Updated 17 June 2015

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 is 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.

On 1 April 2015 the Care Act 2014 came into force. To accommodate the introduction of this new Legislation there is a short transition period. Therefore within this inspection report two sets of Regulations are referred to. These are, The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. All new inspections will only be completed against the new Regulations - The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We carried out this inspection on 5 and 9 February and it was announced. The provider was given 48 hours’ notice. Notice was provided to ensure relevant people were in the office to facilitate the inspection process. The inspection was undertaken by two inspectors. The inspection included two visits to the main office that was the registered location. We also visited the two Extra Care Housing schemes where the provider provides personal care and support to people living in a development of flats.

Before our inspection we reviewed the information we held about the home, which included previous inspection reports, safeguarding alerts, associated investigations undertaken by the local authority and notifications received. A notification is information about important events which the service is required to send us by law. We spoke with the Local Authority Contracting Team, who has responsibility for monitoring the quality and safety of the service provided to Local Authority funded people. We also spoke to an operations manager who worked for the local authority. We used all this information to decide which areas to focus on during our inspection.

On the inspection days we spoke to two acting branch managers, two team leaders, one supervisor and three care co-ordinators. Following the office visits we spoke to 11 staff on the telephone. These contacts included supervisors and support workers. We also visited both of the Extra Care Housing schemes and spoke to six staff working at the time of our visits. This included team leaders and support workers.

We spoke to 34 people who received care and support within their own home and 11 people who lived in the Extra Care Housing schemes who received a service from the staff working on site from MiHomecare – Seaford.

During the office visits we looked at 13 staff files, complaint and safeguarding records and quality review checks. We reviewed the computer systems used for booking and co-ordinating the work schedules for staff and 15 files containing care records which were held in the office. When visiting the Extra Care Housing schemes we saw five further care record files held within people’s own flats and four further staff files. The care records included the individual care plan, associated risk assessments and Medicine Administration Records. (MAR charts)

We observed care and staff interaction with people during the visits to the Extra Care Housing schemes, this included the administration of medicines. During our office visits we heard staff talking to people who used the service.

Updated 17 June 2015

MiHomecare – Seaford is a domiciliary care agency (DCA), based in Seaford. It provides personal care and support to older people living in their own homes covering a large area incorporating Eastbourne, Seaford, Lewes and Peacehaven. People receiving this care had varied care and support needs. This included help with personal washing, the administration of medicines and support in the preparation of food. Some people had memory loss and lived with dementia. Other people had mobility problems and needed assistance in moving, often with the support of two staff and equipment.

In addition the agency had a contract with the local authority to provide personal care and support to people who lived in two Extra Care Housing schemes. These provide a number of self-contained flats that were managed by a separate organisation. These developments have communal sitting areas and food was provided through a kitchen on site if wanted. People over the age of 60 years rent or buy a flat and the agency provides 24 hour contact service for extra care or emergencies. Personal support and care is available on a regular basis if people want this service. One of the schemes is located in Peacehaven and is called Downlands Court. The other is located in Uckfield and is called Margaret House.

This inspection was announced with the provider given 48 hours’ notice. The inspection took place on the 5 and 9 February 2015.

The DCA did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered provider must ensure the registered location had a registered manager in accordance with their condition of registration. The DCA had lacked leadership and clear management for the past year.

Medicines were not always managed safely. Records were not always accurate and systems did not ensure that variable dosage medicines and other prescribed medicines were given as required.

Recruitment records did not confirm the provider had assured themselves that staff working had relevant checks undertaken to ensure they were suitable to work with people at risk.

Written and verbal complaints were not always responded to in a timely and proactive way. This meant information of concern was not always used to improve the service and some complainants did not have their concerns addressed.

The management of the service did not ensure that the Statement of Purpose (SOP) had been revised and updated to reflect the current practice of the DCA as required, or that notifications were sent to the CQC in accordance with legal requirements.

The provider had not established quality monitoring systems across the service. Ways of reviewing the care and improving the care and quality of the service were not in place.

The scheduling of staff allowed for staff with the correct skills and approach, that met people’s preferences, to care for people at times that met people’s needs. People felt safe and liked the support workers who looked after them. Risk assessments were undertaken to identify and minimise risk as far as possible. Communication between people and the office staff was not always effective although feedback indicated this had improved over recent weeks.

Staff training had been reviewed and established with a training co-ordinator to schedule and monitor staff completion of essential training. Induction training was completed and all staff had either undertaken or were in the process of completing the Organisational induction programme. Staff had the opportunity to develop their skills with additional training if they wanted to. Systems for monitoring and supervision of staff were being developed, but were not in place for all staff.

People were looked after by staff who were caring and kind and took account of people’s privacy and dignity. They worked with other health and social care professionals to promote a person centred approach and as much independence for people as possible. People had their health care needs attended to with the support and guidance of additional health and social care professionals when required.

People said they were happy with the care and support staff provided to them and that it met their individual needs. However, not all care plans and assessments were completed in a consistent way. Some documents were missing from files and other information was not up to date. This may lead to staff not fully understanding the care needs of people.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we have taken at the back of the full version of the report.