Background to this inspection
Updated
1 September 2022
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was completed by one inspector and an Expert 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.
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 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. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was not a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 20 June 2022 and ended on 29 June 2022. We visited the location’s office on 20 June and 27 June 2022.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and three relatives to gather their view on the care received. We spoke with eight members of staff including the area manager, office co-ordinators and care assistants. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed six care plans, a range of medicine administration records (MAR), three staff files and other records relating to the quality and safety of the service.
After the inspection
We continued to review evidence provided by the area manager. This included another three care plans and a number of competency check documents. We sought further feedback from the local authorities who worked with the agency.
Updated
1 September 2022
About the service
MyLife (East Sussex) is a domiciliary care agency providing personal care to people living in their own homes. They cover Brighton and Hove, East Sussex and West Sussex, and have an additional branch office in West Sussex. The service provides support to people with a wide range of different health care needs. At the time of our inspection, there were 143 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
People did not always receive consistent and reliable care. Several care calls had been missed in recent months. Care call scheduling was not robust with some calls not covered on the day of our first site visit. We addressed this with the area manager and action was taken to improve this, we completed a second visit a week later and saw improvement.
Staff training was not up to date. Some competency checks had been completed however there remained a risk that not all staff had the correct skills and experience to provide safe care to people. Record keeping at the service was inconsistent, for example medicine administration records contained gaps. This was due to an issue with the electronic care system, not that the medicine was being missed. This was an area being addressed by the quality lead.
There was a lack of managerial oversight at the service. The quality assurance processes had not identified and addressed the concerns. Accident and incidents were not routinely reviewed to identify and address any themes or patterns in order to improve the service. The area manager was placed in the office following our first site visit until a new manager could be recruited.
People told us they felt safe with care staff in their homes, and most spoke positively about the care they received. We received mixed feedback from people regarding being given the opportunity to improve the service, however people told us they felt able to contact the office should they have any concerns.
People were treated with respect and dignity by care staff who knew their needs and preferences well.
Care plans and risk assessments contained information to guide staff on how to support people in the way they preferred and minimise risks. The provider had an up to date safeguarding policy in place and staff demonstrated good knowledge of what to do should they have concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 18 February 2021).
Why we inspected
We received concerns in relation to care calls being missed, cancelled and not scheduled effectively. We also received concerns that incidents were not being thoroughly investigated. There were also concerns over a lack of managerial oversight at the service and negative culture within the office staff. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led only.
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 good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, caring and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
Since our inspection the provider has supplied an action plan detailing how they are addressing our concerns and minimising risk to people who use the service. This includes the area manager overseeing the management of the service, more robust scheduling of care calls, and arranging training.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for MyLife (East Sussex) on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to people receiving safe and consistent care, staff training and managerial oversight of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.