Background to this inspection
Updated
15 July 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.
This inspection took place on 2 and 8 June 2015 and was announced. The provider was given notice because the location provides a domiciliary care service. We needed to be sure that the staff would be available in the office to assist with the inspection.
The inspection was carried out by one inspector.
Before the inspection we looked at the Provider Information Return (PIR) which the provider sent to us. This 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 also looked at all the information we have collected about the service. This included notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law.
On the day of the inspection we spoke with the team leader and the quality and performance manager, four staff and representatives from the local authority commissioning team. Following the inspection we spoke with eight people who use the service (three people’s relatives spoke on their behalf), the local authority’s safeguarding team and the provider’s area manager. We looked at records relating to the management of the service including eight people’s care plans, some policies, and a sample of staff recruitment files and training records.
The local authority’s commissioning and safeguarding teams expressed concerns about the quality of care offered and were conducting regular monitoring visits of the service.
Updated
15 July 2015
This inspection took place on 2 and 8 June 2015 and was announced. MiHomecare – Newbury is a domiciliary care service providing personal care for people living in their own homes.
The service is required to have a registered manager. 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. At the time of the inspection the service did not have a registered manager. The manager who had been appointed for the day to day running of the service left during the week prior to our inspection.
At the last inspection on 4 and 6 August 2014 we told the provider to make sure that quality of care the service offered was properly assessed and monitored. These actions had been completed. The area manager and quality and performance team audited action plans for improvement and all other quality assurance returns completed by the person managing the service. They ensured that actions were completed in a timely way.
People who use the service and care staff’s views were listened to. Staff told us that the management team were open and responsive and they were confident to express their views. The service worked closely with other professionals to try to improve the quality of the service.
At the last inspection on 4 and 6 August 2014 we told the provider to make sure that any medicines given by care staff were given safely. Some of these actions had been completed but there were areas where the arrangements for the safe administration of medicines were not clear. The provider had not met the requirements of the regulation. Staff had been trained in the administration of medicines and their competence to do this was tested on a regular basis. However, some care plans did not describe the support people needed to take their medicines safely and some were contradictory. The local authority expressed concerns about the number of medication errors.
People told us they felt safe using the service. Staff had been properly trained and knew how to protect people in their care. There were enough staff who had been safely recruited to provide appropriate care to people.
At the last inspection on 4 and 6 August 2014 we told the provider to ensure they had suitable arrangements to ask for people’s consent to their care and treatment. This action had been completed. The provider and care staff understood the Mental Capacity Act (2005). The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. Care staff understood consent issues and people told us they made their own decisions. People’s capacity and appropriate paperwork were recorded in care plans.
At the last inspection on 4 and 6 August 2014 we told the provider to ensure staff received appropriate support to carry out their work. This action had been completed. Staff received induction training and their work was reviewed on a regular basis. Staff competencies in various areas of their work were checked regularly.
People told us that care staff usually arrive on time and stay the allocated length of time. The local authority expressed concerns about the number of missed calls.
People told us they were offered good care. They described staff as, ‘excellent, kind and respectful’’. There were some concerns about the length of time it took ‘office staff’ to respond to people.
We recommended that the provider review the numbers and deployment of support staff needed to deal with communications from people who use the service, in a timely way.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.