Ohio Home Care Limited

Ohio Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to younger disabled adults, older people, including people living with dementia. 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.

At the time of the inspection 80 people were receiving personal care.

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

We received mixed feedback from people and their relatives about the care and support they received, which showed levels of care and communication was not always consistent across the service.

The majority of feedback was positive about the kind and caring attitude of staff and people and their relatives felt their regular staff knew them well and had developed positive working relationships.

However, issues were raised related to timekeeping and how the management dealt with concerns and complaints. There were inconsistencies with the effectiveness of communication with the management team.

Whilst risks to people's safety were assessed, control measures and guidance for staff to follow to manage these risks were not always recorded to highlight how people could be supported safely. After discussions with the provider, the relevant information was sent to us after the inspection.

There were some inconsistencies with the information recorded in people’s daily logs which meant important details and information related to care and support had not always been recorded.

People were supported by staff who enjoyed working for the company and spoke positively about their working environment and the support they received.

There were monitoring and auditing systems in place to identify any issues with the quality of the service.

The provider told us that the COVID-19 pandemic had brought about a range of challenges within the health and social sector, including the recruitment and retention of staff, especially within the current cost of living crisis. They acknowledged where improvements needed to be made.

Despite attempting contact with a large number of the care staff, we only heard back from a small sample, which was not fully representative of a service of this size with 50 active care staff. The provider told us this had been a challenge and had encouraged staff to engage with us as part of the inspection process.

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.

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. We considered this guidance as there was one person using the service who has a learning disability and/or who are autistic.

We have made two recommendations about care planning and risk management records and the management of complaints.

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 good (published 24 August 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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

Ohio Home Care Limited is a domiciliary care agency which provides personal care and support to people living in their own homes. It provides a service to older and younger adults, including people living with dementia and people with chronic health care needs and/or a disability. Not everyone who used the service received 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 inspection the service was providing personal care to 45 people.

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

People and their relatives told us they were pleased with the quality of their care and support. We found positive written comments from other people who used the service and their representatives when we looked at the provider's surveys and other quality monitoring documents. Staff were complimented for their kindness, compassion and reliability.

People were protected from the risk of harm. Staff were trained to protect people from the risk of abuse and neglect, and trained to safely administer prescribed medicine. The management team audited medicine records and carried out 'spot check' visits to ensure staff competently supported people to take their medicines, although we found one medicine record where a staff member had incorrectly described how they supported a person. Risk assessments had been carried out to identify and minimise risks to people's safety, for example staff followed moving and handling guidance that was tailored to people's individual needs and circumstances. People received care from safely recruited new staff, however the provider needed to more rigorously evidence that references were properly validated to confirm authenticity. People were protected from the risk of cross infection as staff received training and wore personal protective equipment.

People received their care from staff with appropriate training, supervision and support to carry out their roles and responsibilities. People's care files demonstrated their needs were suitably assessed in order to develop their care plans. People and their relatives told us they felt consulted about their social and health care needs, preferred routines and other wishes about how their care and support should be provided.

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.

Staff understood about seeking people's consent and the provider had recently strengthened the written information about people's capacity to give consent within their care files. People and their relatives told us they were asked for their feedback about the service and told us they received a stable and smoothly delivered service.

Some relatives told us they were pleased with how the provider had matched their family members with staff who shared the same linguistic skills, and an understanding of people's cultural needs but we also noted comments that some staff needed to improve their English language skills. This was being addressed by the provider.

People and their relatives were familiar with the provider's complaints procedure and people thought their concerns would be looked at in an open and professional manner. The complaints investigations we looked at showed that the provider implemented changes to improve the service by learning from complaints. We noted the provider needed to ensure that full written documentation in relation to the outcomes of complaints was maintained at all times.

People who used the service, their relatives and staff spoke positively about how the service was managed. Relatives stated they would recommend the service and staff stated they could always get advice from their line managers. The provider was working on improvements to the service following a visit from a local authority contracts monitoring team.

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 Good (published on 24 November 2017).

Why we inspected

This was a planned comprehensive inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection took place on 29 August, 6 September and 21 October 2016. We gave the provider two days’ notice that we would be carrying out an inspection. This was because the service provides personal care to people living in their own homes and we needed to ensure that key staff would be available. This was the first inspection of this service since it’s registration in January 2014. The provider was previously inspected at its former location in December 2012 and met the regulations inspected.

There was a registered manager in post at the time of the 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 meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Relatives told us their family members felt safe and at ease with care staff. Care staff understood how to identify different types of potential or actual abuse and were aware of their responsibility to immediately report any safeguarding concerns to their line manager. Risks were assessed and individual written guidance was produced for staff, to enable people to safely receive care and support in their own homes, in accordance with their own wishes. However, some staff were not familiar with the provider’s whistleblowing policy.

People were supported by staff who had been recruited in a thorough and safe manner. Staff had received training about how to safely prompt or assist people with their prescribed medicines. However, at the time of this inspection people received any required medicines support from their relatives.

People were consulted and supported to make choices about how their care and support was given. The provider had systems in place to ensure that people’s rights were protected and staff gave us detailed accounts of how they always sought people’s consent before providing care and support. Staff had not yet attended training about the Mental Capacity Act 2005 (MCA) but arrangements had been made for this training to be delivered.

People were ordinarily supported by their relatives to liaise with health and social care professionals by their relatives. Where required, staff supported people to meet their nutritional and hydration needs. Care staff reported any concerns about people’s day-to-day wellbeing, health care needs and safety to the registered manager and they understood when it was necessary to seek emergency help.

Relatives told us they were confident that staff had received appropriate training and support to effectively understand and meet people’s needs. The provider’s training and development programme showed that staff received mandatory training, regular supervision and support to access national health and social care qualifications.

Staff were described by relatives as being, “kind and caring”, “always punctual, so reliable” and “very gentle and nice.” Relatives told us they particularly appreciated how the provider ensured that their family members received a consistently delivered service from a limited number of care staff, which included staff that spoke the same first language of their family.

The provider sought feedback from people and their relatives in order to check how the quality of their service could be improved. Relatives told us they had never had cause to make a complaint and thought that the registered manager would take any complaints seriously.

The service was well managed. Staff told us they felt properly guided and supported by the management team. Relatives were positive about the registered manager’s ‘hands-on’ approach, which was demonstrated by his regular visits to people’s homes and telephone calls to check that the service was meeting people’s needs and expectations. Clear systems were in place to audit and monitor the quality of the service.

We have made one recommendation in relation to staff needing additional training and support to understand the provider’s whistleblowing policy.