Background to this inspection
Updated
23 May 2017
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 13 and 14 March 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available.
The inspection team consisted of two inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed safeguarding records and other information of concern received about the service. We checked if notifications had been sent to us by the service. A notification is information about important events which the provider is required to tell us about by law. We spoke with the Local Authority safeguarding and commissioning teams. This inspection was brought forward as a result of receiving some concerning information about the service.
Before the inspection we asked the provider to complete and send a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. The provider sent us this information.
During the inspection we spoke with 26 people who used the service and eight relatives. We also spoke with 16 care staff, one field care supervisor, two co-ordinators who planned people’s care, the quality and performance manager and the registered manager.
We reviewed a range of records about people’s care and how the service was managed. We looked at plans of care for seven people which included specific records relating to people’s mental capacity, health, choices, medicines and risk assessments. We looked at daily reports of care, incident and safeguarding logs, compliments, complaints, service quality feedback forms, audits and minutes of meetings. We looked at the training plan for 63 care staff, recruitment records for four staff members, spot check and supervision records for six staff members.
We asked the provider to send us information after the visit. This information was received.
Updated
23 May 2017
This inspection took place on 13 and 14 March 2017. The inspection was announced.
MiHomecare-Havant provides personal care services to older people, adults with disabilities and adults living with dementia in their own homes. At the time of our inspection there were 151 people receiving care and support from the service. The service had reduced the number of people they were providing care for as a result of the concerns identified at the last inspection on 11 and 12 April 2016. There were 63 care staff, two field care supervisors, two co-ordinators who planned people’s care, one part time administration assistant, a quality and performance manager and 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.
Reliance on agency staff to maintain staffing levels was still a concern; however improvements had been made with missed visits and late calls. People felt they received safe care but felt the security of their homes were being put at risk due to the lack of continuity of care workers particularly at the weekends.
Risks associated with people’s care were managed but documents did not always contain sufficient information on how to support people with equipment and this information was not always included in their care plans.
Permanent staff had the skills and knowledge to care for people and meet their needs. However, agency staff were provided with the appropriate training but they had not had their competencies assessed. Staff received a regular supervision but had not received an appraisal at the time of the inspection.
People’s care records did not always contain sufficient detail, however people told us they felt staff met their needs and did not have any concerns that they were receiving incorrect care.
People did not always feel the management team were professional. However people had seen an improvement in the management of the service since the current registered manager joined the service.
Staff demonstrated a good understanding of safeguarding processes and were able to identify potential signs and symptoms of possible abuse and they knew how to report these concerns
Safe recruitment and medicines practices were followed.
Staff were kind and caring and people were fully involved in and consented to their care. Staff had a good knowledge of the Mental Capacity Act 2005.
People were supported to eat and drink sufficiently and had regular support to access Healthcare professionals when needed.
People’s privacy and dignity was respected. Compliments had been received and complaints were dealt with appropriately. Staff were supported to question practice and felt supported. Staff were recognised when they had worked hard and made a difference to people.
Audits were in place to assess the overall quality and safety of the service which were analysed to continually improve service delivery. Safeguarding concerns were appropriately investigated.
The services rating from their last inspection in April 2016 had been displayed conspicuously.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.