J.C.Michael Groups Ltd Hackney

J.C. Michael Groups Ltd is a domiciliary care agency providing personal care for people living in their own homes. At the time of our inspection there were 208 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

People were protected from harm as the provider had an effective safeguarding process in place. Staff understood how to ensure people were protected from the spread of infection. Medicines were managed safely. Staff were recruited safely.

The provider assessed people’s needs before the service began, which meant they could meet their care needs. People were involved in their care and could make decisions. Staff had training and regular support from the management team. People had their nutrition and hydration needs assessed. Staff worked with health care professionals to meet people’s needs. Staff asked people permission before providing care to them. 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.

Right Care:

People told us staff were kind and caring. People said they were treated with respect, however some people told us they did not always have the opportunity to give feedback. We spoke with the registered manager about this and they showed us a survey that had been sent out to everyone using the service to obtain their views. Staff told us they promoted people’s independence and protected people’s dignity.

People had care plans in place, people’s likes and preferences were recorded. People told us that staff communicated with them well. Records showed that people’s communication needs were recorded. People, staff and relatives told us they knew how to make a complaint. The provider had a complaints procedure in place.

Right Culture:

The provider had a call monitoring system in place, the data we analysed showed staff were often late on visits and in some cases did not stay for the allocated time. The provider had picked up on these issues through their auditing process and had taken steps to address them, however some of these issues were still not fully addressed.

There were mixed views about the communication from the office, some people said it was good and some said it was not good at all. The staff told us they felt supported by the management team. The provider had an auditing system in place which for the most part was effective. We have made a recommendation about the call and visit monitoring system. People told us overall they felt safe. Risk management plans were in place, we have made a recommendation about improving risk assessments.

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

The last rating for this service was requires improvement (published 18 November 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider considers current guidance to ensure care visits are delivered as per agreement. At this inspection we found some improvements had been made however we have recommended the provider make further improvements to address issues of staff lateness and visit times.

Why we inspected

The inspection was prompted by a review of the information we had about the service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. 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.

J.C. Michael Groups Ltd Hackney is a domiciliary care service registered to provide personal care support to people with dementia, learning disabilities, mental health, older people, physical disability, sensory impairment, and younger adults. 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. Not everyone who used the service received personal care. At the time of the inspection 127 people were receiving personal care support.

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

People and relatives told us regular care staff were punctual. However, they told us staff who were temporary or covered weekend and evening shifts were not always as reliable. We have made a recommendation in relation to care visits being delivered per the agreed time.

Staff supervision records were not up to date. People’s needs assessments records were not always completed in a timely manner. The provider’s monitoring and auditing systems were not effective.

People and their relatives told us they felt safe and systems were in place to safeguard people. Risks to them were identified and managed. People’s medicines needs were managed safely. Infection control measures were in place to prevent cross infection. People were supported by staff who were recruited safely. Accidents and incidents were investigated, and lessons were learnt to minimise their recurrence.

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’s healthcare associated risks were identified and assessed. People’s needs were met by staff who were well trained and received regular support and supervision. People’s dietary needs were met effectively.

People told us regular care staff were caring and treated them with respect and dignity. People were involved in making decisions regarding their care. People were supported to remain as independent as possible. People’s cultural and religious needs were respected when planning and delivering care. The service respected and welcomed lesbian, gay, bisexual and transgender people to use the service.

Care plans were up to date, person centred and reviewed regularly. The provider had a complaints procedure in place and people knew how to make a complaint. People were supported with end of life care.

Staff told us they felt supported by the registered manager and the provider. The service worked well with other organisations to improve people’s experiences.

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 requires improvement (published 24 October 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to person-centred care and 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 for 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.

This service is a domiciliary care agency. It provides personal care to people living in their own homes and flats in the community. It provides a service to adults with support needs including older people, people with physical disabilities, people with mental health conditions and people with learning disabilities. At the time of our inspection they were providing care to 114 people. Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post. 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.

People told us they felt safe with their care workers. The provider acknowledged they needed to update care plans and risk assessments to ensure they contained sufficient information about how to mitigate risk and support people with their medicines. They started this process during the inspection.

People received care from regular care workers who were recruited in a way that ensured they were suitable to work in a care setting. The staff scheduling meant people did not always receive care at the time it had been scheduled. We have made a recommendation about staff deployment.

Staff were knowledgeable about safeguarding adults from harm and knew how to escalate any concerns they had. Incidents were investigated and action was taken to ensure incidents were not repeated.

People were involved in writing and updating their care plans. Records showed people received the care they needed. People were supported to access healthcare services and received the support they needed to maintain their health. Care workers supported people to eat and drink enough to maintain adequate nutrition and hydration.

People consented to their care, and were offered choices. Where people lacked capacity to consent to their care and treatment the service applied the principles of the Mental Capacity Act 2005.

Staff demonstrated a compassionate approach and attitude to supporting people. They spoke about upholding people’s dignity and treating them with respect. The service respected people’s cultural and religious backgrounds and the impact this had on their care preferences. The service created a safe space for people to disclose their sexual and gender identity.

People were asked to provide feedback about their experience of care through regular telephone surveys and questionnaires. People knew how to make complaints. Complaints were responded to appropriately and apologies were given when appropriate.

The provider had a policy framework in place to support people at the end of their lives. However, people were not being asked for their views in advance in line with the framework. We have made a recommendation about end of life care.

Staff spoke highly of the registered manager and we saw there was an open and friendly atmosphere in the office. The values of the organisation were clear and on display for staff to refer to. The registered manager completed a range of audits and quality assurance checks. However, the processes to ensure oversight, analysis and improvement were not yet embedded. We have made a recommendation about quality assurance systems.