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Archived: MiHomecare - Newbury

Overall: Requires improvement read more about inspection ratings

1st Floor, 9 Thatcham Business Village, Colthrop Way, Thatcham, Berkshire, RG19 4LW 0333 121 8301

Provided and run by:
MiHomecare Limited

All Inspections

02 June 2015

During a routine inspection

This inspection took place on 2 and 8 June 2015 and was announced. MiHomecare – Newbury is a domiciliary care service providing personal care for people living in their own homes.

The 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. 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. At the time of the inspection the service did not have a registered manager. The manager who had been appointed for the day to day running of the service left during the week prior to our inspection.

At the last inspection on 4 and 6 August 2014 we told the provider to make sure that quality of care the service offered was properly assessed and monitored. These actions had been completed. The area manager and quality and performance team audited action plans for improvement and all other quality assurance returns completed by the person managing the service. They ensured that actions were completed in a timely way.

People who use the service and care staff’s views were listened to. Staff told us that the management team were open and responsive and they were confident to express their views. The service worked closely with other professionals to try to improve the quality of the service.

At the last inspection on 4 and 6 August 2014 we told the provider to make sure that any medicines given by care staff were given safely. Some of these actions had been completed but there were areas where the arrangements for the safe administration of medicines were not clear. The provider had not met the requirements of the regulation. Staff had been trained in the administration of medicines and their competence to do this was tested on a regular basis. However, some care plans did not describe the support people needed to take their medicines safely and some were contradictory. The local authority expressed concerns about the number of medication errors.

People told us they felt safe using the service. Staff had been properly trained and knew how to protect people in their care. There were enough staff who had been safely recruited to provide appropriate care to people.

At the last inspection on 4 and 6 August 2014 we told the provider to ensure they had suitable arrangements to ask for people’s consent to their care and treatment. This action had been completed. The provider and care staff understood the Mental Capacity Act (2005). The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. Care staff understood consent issues and people told us they made their own decisions. People’s capacity and appropriate paperwork were recorded in care plans.

At the last inspection on 4 and 6 August 2014 we told the provider to ensure staff received appropriate support to carry out their work. This action had been completed. Staff received induction training and their work was reviewed on a regular basis. Staff competencies in various areas of their work were checked regularly.

People told us that care staff usually arrive on time and stay the allocated length of time. The local authority expressed concerns about the number of missed calls.

People told us they were offered good care. They described staff as, ‘excellent, kind and respectful’’. There were some concerns about the length of time it took ‘office staff’ to respond to people.

We recommended that the provider review the numbers and deployment of support staff needed to deal with communications from people who use the service, in a timely way.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

4, 6 August 2014

During a routine inspection

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with six of the 63 people who use the service or their representatives, the interim manager, the provider's project manager for the region, seven care staff, one care manager and two local authority commissioners of services. We also reviewed records related to the management of the service which included, six care plans, medication administration records, daily care records, three monthly provider's audit, client satisfaction survey results for the year 2013/2014 and staff training records.

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.

Is the service safe?

People experienced care and support that was planned and delivered in a way that was intended to ensure people's safety and welfare. However, people were not protected against the risks associated with medicines because the service was not following the arrangements in place for the safe management of medicines.

Prior to accepting a new client, a full assessment of care needs had been supplied to the service by the people's care managers. We saw that after the package of care was put in place and the service provision had started MiHomecare then carried out their own comprehensive and person centred assessment. In instances where the person was not funded by the local authority we saw the service carried out their own assessment prior to offering a package of care. Risk and other assessments were included in the care plans. Any risks identified during the assessment process were seen to then be addressed, with staff actions to reduce the risk being included within the person's care plan.

Is the service effective?

People we spoke with told us they felt their needs were being met and their care was delivered in the way they preferred. One person told us: "I cannot fault the care."

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 which applies to all services providing care and support for people. Staff we spoke with demonstrated a good understanding of people's rights to make their own decisions. However, arrangements were not in place for ensuring only those lawfully able to give consent were asked to do so where the person receiving the care lacked capacity to consent. Where people lacked capacity to consent to their care, there were no arrangements in place for establishing if anyone was able to lawfully consent on their behalf. Where the person lacked capacity and there was no one able to lawfully consent to care on their behalf, there were no arrangements in place for establishing and recording that care was in their best interests.

The provider had not ensured staff were appropriately supported to enable them to deliver care and treatment to people who use the service safely and to an appropriate standard. Staff were not always receiving appropriate training and supervision.

Is the service caring?

People we spoke with told us staff always double checked with them that they wanted help with their care needs and asked before providing any assistance. They confirmed staff took time to explain what was happening and make sure they agreed with any changes. One person commented "They are all very nice, they're absolutely brilliant." and another said, "On the whole I am very happy."

Is the service responsive?

A relative we spoke with described how a member of staff had stayed at the end of a call to help in an emergency situation. The relative said the staff member was: "really nice and really, really helpful." The relative also added that all staff were: "really helpful all the time."

People we spoke with all knew how to raise a concern, should they need to. All felt the staff and office would listen to and act on any concerns or complaints they raised.

Is the service well-led

The provider had systems in place to regularly assess and monitor the quality of service that people received and to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. However, those systems were not always effective as resultant improvement plans were not fully actioned within the timescales set.

Care managers and commissioners we spoke with told us they had no concerns with the service provided. One commissioner told us the service responded quickly if any issues were raised and that the communication from the service to them was good.

The service has been without a registered manager since December 2013. The provider had employed a new manager to start in May 2014 but that applicant did not take up the position. The provider re-advertised and was in the process of interviewing new applicants at the time of this inspection.