The Care Quality Commission
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Archived: MiHomecare - Wisbech

Overall: Good read more about inspection ratings

1 Castle Mews, Wisbech, Peterborough, Cambridgeshire, PE13 1HB (01945) 588050

Provided and run by:
MiHomecare Limited

Important: The provider of this service changed. See old profile

All Inspections

01 and 02 April 2015

During a routine inspection

MiHomecare - Wisbech is registered to provide personal care for people who live at home in and around the town of Wisbech. Its main office is located in the town centre and has accessible premises and parking for people living with a disability. The agency provides personal care for approximately 100 people.

This unannounced inspection took place on 01 and 02 April 2015.

At our previous inspection on 29 May 2014 the service was not meeting one of the regulations that we assessed. This was in relation to the management of people’s medicines. The provider sent us an action plan telling us that they would make the necessary improvements by 06 July 2014. At this inspection of 01 April 2015 we found that the necessary improvements had been made.

The service had a registered manager in post. They had been in post since October 2014. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered managers, 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 manager had a robust recruitment process in place. This helped ensure that only staff of the right calibre and with suitable qualifications were offered employment. There was a sufficient number of suitably qualified and experienced staff working at the service. New care staff were provided with an induction to the service and were supported through this.

Staff had been trained in medicines administration and safeguarding people from harm and were knowledgeable about how to ensure people’s safety. People were supported with their prescribed medicines by staff whose competency to safely administer these has been assessed regularly.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that the registered manager and staff were knowledgeable about when a request through the Court of Protection for a DoLS would be required. We found that no applications to lawfully deprive people of their liberty were required but the registered manager and senior staff were aware of the action to take if this was required. People’s ability to make decisions based on their best interests had been clearly documented to demonstrate which decisions they could make.

People’s care was provided by staff who always respected their privacy and dignity. People’s care was provided with compassion and in a way which people really appreciated. People were informed if care staff were going to be delayed.

People’s care records were held securely, were up-to-date but contained limited information for staff to follow. This meant that people were at risk of receiving inappropriate care. People and where required, their relatives, were involved in the assessment and development of their care needs.

People were supported to access a range of health care professionals. This included their allocated GP and community nursing services. Risks to people’s health were assessed and promptly acted upon according to each person’s needs.

People were able eat their preferred drinks and meals. People were supported to eat soft or pureed diets where this had been deemed as being required by health care professionals. People were supported to ensure they had access to sufficient food and drinks.

People, relatives and staff were provided with information on how to make a complaint and staff knew how to respond to any reported concerns or suggestions. People were satisfied with the response they received. Action was taken to address people’s concerns and to reduce the risk of any potential recurrence.

The registered manager had effective quality assurance processes and procedures in place, such as audits, spot checks and supervision meetings with staff to improve, the quality of people’s support and care. People were supported to raise concerns or comment on the quality of their care.

28, 29 May 2014

During a routine inspection

We visited the service and people in their homes on the first day of our inspection and then contacted people by telephone on the second day. We spoke with eight people, spoke with seven staff, visited two people in their homes, spoke with three relatives and looked at five people's care records.

We considered our inspections findings to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

This is a summary of what we found-

Is the service caring?

People were provided with care based upon their assessed needs. However, this was not always done reliably and was not always planned well to protect people from unsafe or inappropriate care. Risks to people's health had been assessed and recorded. However, this did not include specific risks such as those for medicines which had to be administered under strict conditions. People would be supported in the event of a foreseeable emergency by trained staff.

Is the service safe?

People were supported with their medicines administration. Information and guidance for some people's medications was limited and put people at an increased risk of being unsafely administered their prescribed medicines. Staff had been trained on administering medicines but this did not include that for medicines which had to be administered under specific conditions. The provider only recruited and employed staff whose good character had been reliable established. Appropriate checks had been completed by the provider to ensure that only staff who had been deemed fit and suitable were offered employment with the service. Staff had a good knowledge of the procedures to be followed should they ever need to report any Safeguarding safeguarding of vulnerable adults (SOVA) concerns.

Is the service effective?

Staff were provided with regular training and updates when this was required. Records we looked at confirmed that the majority of staff were up to date with their training needs. Staff we spoke with told us that they were able to gain health care qualifications appropriate to their role. Where changes were required to people's care and support needs, we saw that these had been implemented. This was for things such as additional moving and handling equipment or the provision of extra staff to support people.

SOVA policies and procedures we looked at were up to date. Information was displayed on the SOVA to maintain staff's awareness on this subject. People were reliably supported to see, or be seen by, health care professionals.

Is the service responsive?

Quality assurance processes were in place to ensure that people were provided with care based upon their most recently identified needs. People we spoke with confirmed to us that they had a positive or very positive experience of using the service. We saw that audits and checks had regularly been completed to ensure people's needs would be consistently met. One person we spoke with said, "I did have a few issues to start with but these have all now been sorted." I can't fault them."

Two new field supervisors had been recruited to check that people's needs were met and that staff were working to the required standard. People's plans of care had been developed with them and were based upon an accurate assessment of people's needs. This ensured that people's needs were consistently met by staff. Where accidents or incidents had occurred we saw that appropriate action had been taken to prevent, or reduce, the potential for any repeat occurrences. However, analysis of this information had not taken place to identify any potential trends. We saw that people using the service had not been unlawfully deprived of the liberties.

Is the service well led?

At the time of our inspection the registered manager was on long term leave. As an interim measure the provider had out a temporary manager in place to ensure that the agency was well led. The temporary manager was in the process of identifying what actions needed to be taken to ensure people received good quality care. Staff and the temporary manager told us that if ever they had any concerns or something needed changing that action was taken as soon as practicable. Staff told us that they were also supported by senior managers who visited the service.