May's Homecare Limited

May's Homecare Limited is a domiciliary care agency that provides care and support to people in their own home at the time of this inspection, six people were using the service.

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

Our last inspection identified shortfalls related to the running of the service. Governance of the service was ineffective, and the provider did not have systems and processes in place to monitor service delivery effectively. The shortfalls we identified related to the lack of adequate assessment of risks to people's health and wellbeing and risks associated with delivering care. Further shortfalls concerned recruitment procedures, working alongside external health and care professionals, the lack of personalised care planning, and limited managerial oversight of the service.

At the last inspection, we found several breaches of legal requirements. We issued a warning notice to the provider and requested an action plan be sent to us to show us how the service was going to improve care. At this inspection we found improvements had been made in areas of concern, the issues raised in the warning notices and most of the breaches had been addressed. However, the service had not sufficiently addressed the issues relating to recruitment of staff until after our inspection visit.

Risks to people were assessed and regularly reviewed. Staff understood the actions needed to minimise the risk of avoidable harm including the prevention of avoidable infection. Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor

practice.

Staff were committed to providing a high-quality service. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity. Staff knew people well.

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.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well. Care plans contained information about the person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes.

People told us that staff were able to meet their needs and were respectful of their individual preferences. People confirmed the service did not miss any care calls and that staff were always on time.

People received care and support from a small group of staff, which provided consistency.

The registered manager of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.

The provider had improved systems in place to monitor and improve the quality and safety of the service provided.

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

Why we inspected

We undertook this inspection to check the provider had followed their action plan, and to confirm they now met legal requirements related to the Warning Notice and the breaches of the regulations. We carried out a full comprehensive inspection covering all five domains, safe, effective, caring, responsive and well-led.

Rating at last inspection

At the last inspection we rated this service requires improvement (published 23 November 2021)

The provider completed an action plan after the last inspection to show what they would do and by when to improve. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Mays homecare Ltd on our website at www.cqc.org.uk

Enforcement and Recommendations

We have identified a breach in relation to the governance of the service, and made a recommendation in relation to staff recruitment processes.

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 until we return to visit as per our inspection programme. If we receive any concerning information, we may inspect sooner

May's Homecare Limited is a domiciliary care agency that provides care and support to people in their own home. People receiving a service included those with dementia, mental health, physical disabilities and learning disabilities. 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. At the time of our visit the service was providing personal care to 6 people in the boroughs of Harringay and Enfield.

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

We identified shortfalls related to the running of the service. Governance of the service was ineffective and the provider did not have systems and processes in place to monitor service delivery effectively. This was needed to ensure the care was provided effectively, safely and in line with the current national guidelines.

The shortfalls we identified related to the lack of adequate assessment of risks to people’s health and wellbeing and risks associated with delivering care. Further shortfalls concerned unsafe management of medicines, recruitment procedures, working alongside external health and care professionals, the lack of personalised care planning, and limited managerial oversight of the service.

However, relatives spoke positively about the care provided and thought the care staff were kind and caring.

People were not always supported to have maximum choice and control of their lives and we were not assured that staff always supported people in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Staff asked for people’s permission before providing care, however where the consent for care was signed by people’s relatives, there was no evidence to show that these relatives had the legal right to give such consent.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service partially demonstrated how they were meeting the underpinning principles of Right support, right care, and the right culture.

Right support:

We could not always ascertain if the care provided was fully person-centred as people’s care plans lacked personalised information on people’s care needs and how they liked to receive care. Based on the feedback from people and relatives staff promoted people’s dignity, privacy and human rights when providing care.

Right care:

People, their relatives and staff told us when providing care, staff maximised people’s choice, control and independence.

Right culture:

The ethos, values, attitudes and behaviours of leaders did not always ensure people

using services lead confident, inclusive and empowered lives. The managers did not have enough oversight of all the safety concerns and risks related to the running of the service and providing safe care.

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)

This service was registered with us on 22 July 2020 and this is the first inspection.

Why we inspected

We inspected May's Homecare Limited as part of our inspection prioritisation programme. We carried this inspection as we had not inspected this location since it was registered with us in July 2020. We needed to carry out a comprehensive inspection to take an in-depth and holistic view across the whole service, looking at all five key questions to consider if the service is safe, effective, caring, responsive and well-led.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive 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.

Enforcement

We have identified breaches in relation to providing safe care, staffing, need for consent, person -centred care and the governance at this inspection. We made two recommendations about handling people’s money and recruitment.

We issued the warning notice about Regulation 17 (Good governance). 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.