Background to this inspection
Updated
11 August 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was conducted by 1 inspector. An Expert by Experience supported the inspection by making telephone calls to service users and their families. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave a short period of notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started 27 June 2023 when we started to make telephone calls to people using the service. We visited the location’s office on 27 July 2023.
What we did before the inspection
We looked at all the information we held about the provider. This included notifications of significant events and information from members of the public.
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
During the inspection
We spoke with 8 people who used the service and the relatives of 8 other people. We received written feedback from the relatives of 6 people, 8 external professionals and 9 members of staff. We met the registered manager, a supervisor, the training manager and 2 care workers (known by the agency as care professionals).
We looked at care records for people who used the service, the records for staff (including recruitment, training, and support records) and other records used by the provider for managing the service. These included records of meetings, complaints and audits.
Updated
11 August 2023
About the service
St Micheal Care Limited t/a Home Instead Senior Care is a care agency providing personal care and support to people living in their own homes, mainly in the London borough of Hammersmith and Fulham. They provide care to a small number of people living in the neighbouring boroughs.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
At the time of our inspection, the agency was providing personal care to 31 older people. Some people had live-in care workers. This meant they had a care worker who stayed with them during the day and night. Other people had regular visits throughout the day. The minimum visit was for 1 hour.
People’s experience of using this service and what we found
People received extremely good quality care which met their needs and reflected their preferences. The agency worked with others to help develop best practice. Their work had a significant impact for people and their overall experience. For example, work to improve people's diet and mental stimulation.
The agency took a holistic approach to care. They worked with families and health professionals to understand people's needs and suggest ways to improve people's lives and wellbeing. They used technology in innovative ways to help keep people safe and to educate staff to help them understand about people's sensory experiences.
The agency was an important contributor to the local community, providing opportunities for people to socialise. These events were open to all people living locally and not just those paying for their care. They worked with charities and universities to research and implement new ways of supporting people by learning about dementia, and other conditions associated with older age.
The staff were exceptionally well trained. Their training included immersive experiences, group analysis of their experiences as care professionals and learning from professionals.
The provider was forward thinking and had plans to develop the service in response to the needs of people and the local community. For example, they were in the process of recruiting a specialist dementia nurse to provide bespoke guidance and training for groups of staff working with individual people and they had already employed a nutritionist who was helping to improve people's diet and attitude towards food.
There were systems to monitoring and audit the service. These included asking others for feedback, responding to, and learning from adverse events. The registered manager was well known by people using the service, their relatives, staff and the local community. They all found the registered manager approachable and valued their views and input.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 20 August 2019).
Why we inspected
We undertook this inspection based on the date of the last inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.