Background to this inspection
Updated
16 July 2021
The inspection
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.
Inspection team
The inspection site visit on the first day of inspection was completed by one inspector and one pharmacist specialist. An expert by experience carried out calls to people following the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. On the second day of the inspection, one inspector attended the site visit.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses or flats.
There was no registered manager in post at the time of this inspection. 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 the meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Notice of inspection
This inspection site visit took place on 13 and 20 May 2021 and was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the provider. We asked for feedback from the local authority who work with the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We spoke with seven relatives to seek their views about the service. We spoke with the manager, the commercial manager, the managing director, the care coordinator and four members of staff. We reviewed records, including the care records of nine people using the service, and the recruitment files and training records for five members of staff. We also looked at records related to the management of the service such as quality audits, and policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We requested records such as risk assessments, staff meeting minutes, telephone monitoring records, training records and spot check records to be sent to us for review.
Updated
16 July 2021
About the service
My Homecare Bexley & Greenwich is a domiciliary care agency looking after people in their own homes. At the time of the inspection the service supported nine people with their personal care.
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
We found risks were not always identified, and risk management plans were not always in to guide staff on how risks should be minimised. Call times did not always allow for travel time between visits.
We had mixed feedback from relatives about the timing of people’s care and support and some staff did not always attend calls at the scheduled times and some staff did not stay for the whole duration of the scheduled call.
Staff records showed that they were supported through induction and training. However, staff and relatives told us that they had not always received adequate training
Complaints were not always logged and managed appropriately. Staff team meetings were not held on a regular basis through the pandemic.
There has not been a registered manager in place since January 2021 and there was not a clear management structure in place. The provider's quality monitoring systems were not effective. Internal audits did not identify the issues we found at this inspection or if they did remedial action was not taken to drive improvements.
People said they felt safe and that their needs were met. There were appropriate safeguarding systems in place to protect people from the risk of abuse. People were protected against the risk of infection and people told us that staff always wore personal protective equipment (PPE).
Medicines were safely managed. Sufficient numbers of suitably skilled staff were deployed to meet people's needs. There were no accidents and incidents logged since our last inspection in December 2020. Assessments were carried out to ensure people's needs could be met. Assessments were carried out prior to people joining the service to ensure their needs could be met.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff told us they always asked people for consent before providing care and support.
People were supported to eat a healthy and well-balanced diet if required. People had access to healthcare services when required to maintain good health and their independence was promoted. Staff were supported through regular supervisions. The service was not currently supporting people who were considered end of life, but if they did then relevant information would be recorded in their care plans.
People and their relatives (where appropriate) had been consulted about their care and support needs. The provider worked in partnership with key organisations to ensure people's individual needs were planned.
Rating at last inspection and update
The last rating for this service was Good (published 2 February 2021).
Why we inspected
We received concerns in relation to safeguarding and whistleblowing. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led only.
Follow up:
We have not inspected caring key question. Ratings from previous comprehensive inspection for this key question were used in calculating the overall rating at this inspection. Therefore, the overall rating for the service has now deteriorated to requires improvement.
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for My Homecare Bexley & Greenwich on our website at www.cqc.org.uk.