Archived: MiHomecare - Birmingham

A single inspector carried out this inspection. As part of the inspection we spoke to seven people using the service, the relatives of three people using the service, the registered manager, a team leader, two care co-ordinators, a field supervisor and two care workers.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

We spoke with people who used the service. They told us that they felt safe. One person said, 'I feel safe with all of the staff, they are all lovely and kind.'

We spoke with several members of staff and they showed that they understood how to report suspected abuse. We saw that appropriate checks were made on people working for the service to make sure that they were suitable to do so.

We found that the provider's safeguarding procedures were robust and staff understood their role in safeguarding the people they supported. We checked staff training records and saw that staff had received recent training in safeguarding vulnerable adults.

Previously, the agency did not have enough qualified, skilled and experienced staff to meet people's needs. This had caused some difficulties in providing the service in the way people wished. This inspection found that improvements had taken place and that there were usually enough qualified, skilled and experienced staff to meet people's needs.

Is the service effective?

People told us that they were happy with the care they received and the care workers who supported them. We found that care staff knew the people they supported well. The majority of people told us that were usually cared for by the same care staff that care staff usually arrived when they expected them to, or they were informed if staff were going to be late.

People told us that they received the support they needed from care staff and were not rushed by them. One person told us, 'I've never had any trouble with them. When I was ill they took good care of me.' A relative of a person using the service told us, 'The staff don't rush and do all of the care tasks they are supposed to.'

People using the agency told us they had a copy of their care plan and had regular reviews of their care needs.

Is the service caring?

We spoke with people who used the service. They all said that they were pleased with the standard of care provided. One person told us, 'I get the same three carers and they are all really kind.'

People were supported by kind and attentive staff. We spoke with several members of staff. They all displayed a positive attitude towards their role and a caring attitude towards the people for whom they provided a service.

Is the service responsive?

We found that care workers had regular one to one supervision meetings. This meant that care staff had the opportunity to discuss their training and development needs, welfare and any concerns they might have about the people they were caring for.

People using the service, their relatives and staff told us they would feel confident in raising any concerns they had but people had some mixed views about how their concerns had been responded to.

Is the service well-led?

We found that the registered manager had made improvements to the organisation of the service since our last visit. One person told us, 'I was previously thinking of transferring to another agency but now things are much better.' Care workers employed at the agency told us that the registered manager was approachable.

At this inspection we found that people's views had been obtained through the use of telephone surveys. The results of the surveys were generally positive and showed that areas of punctuality and reliability had improved. Some people had commented on difficulties in contacting the office and this reflected what some people had told us.

People who used the service could not be assured that incidents were followed up and appropriate lessons learnt. The systems in place made it difficult to track any incidents that occurred to include if appropriate action had been taken and any patterns or trends had been identified.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

MiHomecare had previously provided these services from two separate locations in Solihull and Birmingham. These had recently closed and a new location had been registered with us. This location had only been open for a few weeks at the time of our visit and this was our first inspection.

As part of the inspection we spoke to five people using the service, the relatives of four people using the service, the regional director, a team leader and four members of staff. The registered manager was not available at the time of our visit.

Is the service safe?

We spoke to people who used the service who generally confirmed they felt safe and were not afraid of any of the staff who came to support them. One person told us, 'The staff are all very honest and I feel safe with them.' One person raised a concern that she had not felt safe when staff had arrived to provide care as had not worn their uniform or had an identity badge.

There were policies and procedures in relation to safeguarding adults but the child protection policy was not available when we visited. We were told that all staff had received training in safeguarding people from abuse but records did not assure us of this.

Systems were not being used to make sure that the manager and staff learn from events such as incidents and complaints. This increases the risk of harm to people and fails to ensure that lessons are learned from mistakes.

We found that people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained. Not all care plans and risk assessments were up to date and this meant that when different staff attended to them there was a risk that care provided would not address care and safety needs.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law.

Is the service effective?

Two people had experienced missed calls and some people told us they had experienced calls that were too early or too late.

People's health and care needs had been assessed and care plans were in place but care plans did not always reflect current needs. . Care plans were therefore not able to ensure that staff had up to date information to consistently meet people's needs.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law.

Is the service caring?

We spoke with people who used the agency and with relatives of people using the agency. The majority of people were complimentary about the staff who supported them. They told us that staff were very caring and competent. One person told us, 'The staff are all polite, all good, they are excellent.'

People told us about the staff supporting them and that they were kind and caring staff. One person told us, 'The carers try to get me to do what I can for myself, they are good like that.' Another person told us, 'If I want anything done they try and accommodate that.' Staff spoke with compassion about the people they were supporting.

Is the service responsive?

Most people said that they could make a compliant if they wanted to. However some relatives told us that their complaints had not been addressed to their satisfaction.

We were told that quality assurance questionnaires had been sent to people using the service or their representatives. We were informed that any completed questionnaires would be returned to the provider for analysis.

A system was in place to record call times but we were told there had not yet been any monitoring or audits taken to monitor the time and length of calls. Therefore at the time of our visit the provider did not have an effective system for monitoring calls which meant there was a risk of people not received the calls they needed. Staff had advised that there was a procedure in place for reporting to the office if they were going to be late to a call. There was no evidence that the reports to the office by staff had been analysed or used to identify how to improve the quality of service provided..

We have asked the provider to tell us how they will make improvements and meet the requirements of the law.

Is the service well-led?

Most of the people we spoke with commented on the agency having staffing difficulties. Some people told us that they did not always know which member of staff would be coming to complete their call. Some people told us they had been supported with care by staff they had not met before and that care staff had not arrived on time.

We found that the agency was not operating in a very effective and well organised way.

The agency was utilizing all staff available to provide the required care and meet visit shortfalls. Sometimes that meant that the office staff, who were also trained in care work, sometimes did visits, which meant less office staff to coordinate the visits.

We found that the provider's quality assurance systems had not yet been fully implemented. The regional director told us that they were aware there had been issues with the transfer to the new location and that the provider intended to conduct a review of the service in the next few weeks.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law.