Archived: MiHomecare - Poole

Updated 8 October 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 checked 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.

This inspection took place on 15, 16, 20 and 22 July 2015. The first day was unannounced. One inspector undertook the inspection.

Before the inspection we reviewed the information we held about the service; this included incidents they had notified us about and their action plan which was created to show how they would remedy the concerns that had been identified. We also contacted the local authority safeguarding and contract monitoring teams to obtain their views.

A Provider Information Return (PIR) had not been requested from the provider. This was because the inspection was undertaken to check compliance with warning notices and compliance actions which were issued at the last inspection. 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.

We visited four people in their and homes and spoke with two other people on the telephone. We also spoke with four relatives and spoke with or had contact with five care workers. We also spoke with the acting manager, the field care supervisor, the care coordinator and the regional manager. We looked at nine people’s care and medicine records in the office and the records in their homes, with their permission, of the people we visited. We saw records about how the service was managed. This included four staff recruitment and monitoring records, staff schedules, audits and quality assurance records as well as a wide range of the provider’s policies, procedures and records that related to the management of the service.

Updated 8 October 2015

The first part of this comprehensive inspection was unannounced and took place on 15 July 2015. Three further days of inspection took place by appointment on 16, 20 and 22 July 2015.

MiHomecare – Poole is a domiciliary care agency which provides personal care to people living in their own homes in the Bournemouth, Poole and Christchurch areas.

The service has not had a registered manager since July 2014. 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.

An acting manager had been in charge of MiHomecare – Poole following the resignation of the registered manager in July 2014. This person did not register with CQC and left the company in March 2015. A new manager had been appointed and was undertaking their induction with MiHomecare during this inspection.

At our last inspection in September 2014 we found breaches in the regulations relating to the care and welfare of people who use the service, safeguarding people from abuse, management of medicines, the recruitment, training and support of staff and the provision of adequate numbers of staff. This inspection was carried out to check that the provider had taken action to put things right.

At this inspection we found a number of breaches of the Health and Social Care Regulations 2008 (Regulated Activities) Regulations 2014. Some of these breaches were repeated because the service had failed to take proper action after the last inspection. You can see what action we have told the provider to take at the back of the full version of this report.

People’s medicines were not managed safely. People’s needs regarding the help they needed to take their medicines or apply prescribed creams had not been properly assessed and planned for and there were no instructions for staff to follow. This meant that people were at risk of not receiving the correct medicine, in the correct quantity, at the correct time.

Systems to manage risk and ensure people were cared for in a safe way were ineffective. Risk assessments were not always undertaken or regularly reviewed when they had been done. Some risk assessments identified hazards and concerns but no action had been recorded to show that risks to people had been reduced or managed. This meant that people’s safety and well-being was not always protected.

There were not enough staff employed to meet people’s needs. People did not receive calls at the times they needed and visits were often cut short. Suitable steps had not been taken to ensure that staff were suitably trained and supervised. This meant that people were not always cared for by staff who had been supported to deliver care and treatment safely and to an appropriate standard.

People did not always receive the care they required. Care planning systems were not robust. Some assessments had not recognised specific care needs and no care plans had been created. Some people’s needs had changed and care plans had not been reviewed and amended. This meant that care workers were providing care and meeting needs that had not been fully assessed and planned for.

Management arrangements and systems at the agency did not ensure that the service was well-led. Recruitment systems were not always fully implemented to ensure that staff were suitable to work with vulnerable people. Quality monitoring systems were not used effectively, surveys were not responded to and people were not listened to when they made complaints. Record keeping was poor, as records were out of date and contained errors and omissions.

The overall rating for this service is ‘Inadequate’ and the service  is therefore in  ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.