2M Health & Home Care Services Ltd

Updated 11 October 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 carried out by 2 inspectors. An Expert by Experience made telephone calls to people using the service and their relatives. 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 the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person who used the service and 10 family members to share their experiences of care received. We also spoke with 6 staff members including the registered manager and care workers.

We reviewed a range of records. This included 5 care records, 4 staff files in relation to recruitment and supervision, and multiple medicines records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 11 October 2023

About the service

2M Health & Home Care Ltd is a domiciliary care agency. The service provides personal care to people living in their own homes. At the time of our inspection there were 30 people using the service.

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.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support

Positive behavioural support plans were now in place; however, the records did not provide staff with guidance on how to respond to expressions of distress. 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. We found the records used to assess people's ability to make decisions was not always detailed enough. We have made a recommendation about this in the effective part of this report.

Right Care

Care plans continued to lack information about the support people needed and their preferences. Medicines related documents were completed correctly, however medicines care plans required improvement. Risk assessments were not always in place for people who required equipment to mobilise. People on high-risk medicines did not always have associated risk assessments in place. The provider had safeguarding systems in place and staff were well informed in how to keep people safe.

Right Culture

Systems and processes to assess the quality and safety of the support provided required embedding and sustaining and had not always identified shortfalls. The provider sought feedback from people and those important to them, however where issues were raised, there was no evidence action was taken. Staff had received an induction and training to support them in their role.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 1 September 2023). Breaches in regulations relating to person-centred care, consent, safe care and treatment, safeguarding service users from abuse and improper treatment, good governance, staffing, and fit and proper persons employed were identified. The provider completed an action plan after the inspection to show what they would do and by when, to improve and meet the breaches in regulation related to person-centred care, consent, safeguarding service users from abuse and improper treatment, staffing, and fit and proper persons employed. Warning Notices were served for the breaches relating to safe care and treatment, and governance. At this inspection we found the provider remained in breach of regulations.

This service has been in Special Measures since 1 September 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served had been met and they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 2M Health & Home Care Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.