The Care Quality Commission
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Archived: MiHomecare - Plymouth

Overall: Good read more about inspection ratings

112 Peverell Park Road, Plymouth, Devon, PL3 4ND 0333 121 8501

Provided and run by:
MiHomecare Limited

Important: This service is now registered at a different address - see new profile
Important: The provider of this service changed. See old profile

All Inspections

14 and 19 May 2015

During a routine inspection

The inspection took place on 14 and 19 May 2015 and was announced. At our last inspection on 15, 16, 17 and 22 September 2014 we found breaches of legal requirements related to the assessing and monitoring the quality of service provision and sufficient numbers of suitably qualified, skilled and experienced staff. The provider produced an action plan which explained how they would address the breaches of regulations. At this inspection we found these actions had been completed and improvements had been made.

Mihomecare Plymouth provides domiciliary care services to adults within the Plymouth area. On the day of the inspection Mihomecare was providing support to 266 people. Mihomecare provides a home care service to meet people’s needs including physical disability, sensory impairments and mental health needs including people living with dementia.

The service did not have a registered manager in post. 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. The manager in post had applied to become the registered manager for the service and was awaiting the outcome of their application.

On the day of the inspection staff within the office were relaxed, there was a calming and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were clear, easy to follow and comprehensive.

People all spoke positively about the service they received, one person said “The carers have been a great help to me over the past few weeks. I have not been well at all and they have really supported me with what I need. I would have been in a right fix without them”. Another stated: “I used to be a carer myself, so I know how well they care for me. I have fantastic carers who make it possible for me to live in my own home”.

People told us they felt safe. All staff had undertaken training on safeguarding adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People told us staff provided consistent personalised care and support. Care records gave people control. Staff responded quickly to people’s change in needs. People and those who matter to them were involved in identifying their needs and how they would like to be supported. People’s preferences were sought and respected.

People where appropriate were supported to maintain a healthy balanced diet.

Staff described the management to be very open, supportive and approachable. Staff talked about their jobs in a strong positive manner. Comments included, “The management take an active interest, make themselves available and offer good support”, “I do very much enjoy my job” and “I get sent text messages saying thank you, that makes me feel valued”.

People’s risks were managed well and monitored. There was a culture of learning from mistakes. Accidents and incidents were managed promptly, and were appropriately recorded and analysed. Investigations were thorough. There were effective quality assurance systems in place. Action was taken to address areas where improvements were needed, and as a result, changes had been made to drive the service forward.

People had their medicines managed safely. People were supported to maintain good health. Referrals were made quickly to healthcare professionals, such as GPs, physiotherapists and occupational therapists when people’s needs changed.

People knew how to raise concerns and make complaints. People told us concerns raised had been dealt with promptly and satisfactorily. Any complaints made were thoroughly investigated, recorded and fed back in line with Mihomecare’s own policy.

15, 16, 17, 22 September 2014

During a routine inspection

When the Care Quality Commission inspects health and social care services the inspector works to answer five key questions; is the service safe, effective, caring, responsive and well-led?

In December 2013, the Care Quality Commission issued two compliance actions to the registered persons regarding there not being sufficient numbers of staff, and secondly systems to monitor the quality of service delivery were not satisfactory.

This inspection was completed to check suitable action had been taken to improve staffing levels and quality assurance procedures.

Subsequently at this responsive inspection we wanted to answer the question whether the service was safe and well managed.

During the inspection we were able to speak with 26 people who used the service or the relatives of people who used the service. We spoke with five of these people at their homes, and the other people we spoke with by telephone. We were able to speak also to 8 care staff who worked for the agency.

Below is a summary of what we found.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

No, as a consequence of this inspection, we judged the service was potentially not safe due to people not always receiving support from suitably experienced and skilled staff.

We checked staffing levels at the agency, and assessed whether these were appropriate to meet the needs of people who used the service. Since the last inspection satisfactory action had been taken to ensure appropriate numbers of staff were employed and the number of missed or cancelled visits had been reduced.

Of the people we spoke with most were happy with the care delivered. Everybody told us there were sufficient staff to assist them. Positive comments we received included 'the staff are very good,' 'excellent,' 'they are very friendly, 'the staff are lovely.' People were particularly positive about the regular staff who worked with them.

We did receive concerns about some aspects of the staffing. People who used the service said they had concerns about some staff, usually those who did not work regularly with them. Comments included 'some do not know what they are doing,' and 'they just want to get it done and get away.' Some less experienced staff were at times not deemed at carrying out their duties correctly 'Sometimes they do not do it (their duties) properly.'

Several members of staff and people who used the service said travel time was not built into staff schedules. Some people said this resulted in staff being late, or leaving visits early. This was deemed by some of the people we spoke with to have a negative impact on their care.

Is the service effective?

No, as a consequence of this inspection we judged the service was not effective. This was due to there being inadequate systems to monitor people were protected against the risk of inappropriate or unsafe care.

We checked what systems the organisation had in place to monitor the service was effective, and any risks were minimised. The service had a satisfactory quality assurance policy. However, we did not see evidence this had been satisfactorily implemented. Staff, and people who used the service, raised a number of concerns about the operation of the branch office particularly in relation to communication. For example, we were told 'messages are not passed on,' 'I will ring to say I am not happy about x but they do not do anything.'

31 December 2013 and 3 January 2014

During a routine inspection

Toward this inspection we sent 61 questionnaires to people using the service and an additional questionnaire to a relative or advocate. A total of 36 questionnaires were returned. We spoke to three people using the service, six care workers, the registered manager and regional director for MiHomecare Plymouth. We visited the agency office twice and had information from the local authority commissioning team.

People told us they were treated with respect and their independence was promoted. Some felt they did not receive enough information about the service. People were generally very pleased with the care they received. Comments included, "Most of the carers are very good" and "They have a little chat with you. The one this morning was excellent."

The agency was very proactive in protecting vulnerable people from abuse.

There had been a serious failure in recruitment which had led to some people being unable to receive any visits, in early December 2013. This had not previously been an issue and steps have been taken to correct the failure. However, people's care and welfare had been put at risk.

Staff training and supervision had not been consistent and so staffing competence and support might have been affected. One care worker told us, "The agency seems to be on top of training now". Some staff said they did not feel supported.

The provider organisation changed on 1 July 2013. Those changes affected the running of the Plymouth office adversely and this had put people at risk.