Archived: MiHomecare - Havant

MiHomecare-Havant provides personal care services to older people, adults with disabilities and adults living with dementia in their own homes. At the time of our inspection there were 151 people receiving care and support from the service. The service had reduced the number of people they were providing care for as a result of the concerns identified at the last inspection on 11 and 12 April 2016. There were 63 care staff, two field care supervisors, two co-ordinators who planned people’s care, one part time administration assistant, a quality and performance manager and 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.

Reliance on agency staff to maintain staffing levels was still a concern; however improvements had been made with missed visits and late calls. People felt they received safe care but felt the security of their homes were being put at risk due to the lack of continuity of care workers particularly at the weekends.

Risks associated with people’s care were managed but documents did not always contain sufficient information on how to support people with equipment and this information was not always included in their care plans.

Permanent staff had the skills and knowledge to care for people and meet their needs. However, agency staff were provided with the appropriate training but they had not had their competencies assessed. Staff received a regular supervision but had not received an appraisal at the time of the inspection.

People’s care records did not always contain sufficient detail, however people told us they felt staff met their needs and did not have any concerns that they were receiving incorrect care.

People did not always feel the management team were professional. However people had seen an improvement in the management of the service since the current registered manager joined the service.

Staff demonstrated a good understanding of safeguarding processes and were able to identify potential signs and symptoms of possible abuse and they knew how to report these concerns

Safe recruitment and medicines practices were followed.

Staff were kind and caring and people were fully involved in and consented to their care. Staff had a good knowledge of the Mental Capacity Act 2005.

People were supported to eat and drink sufficiently and had regular support to access Healthcare professionals when needed.

People’s privacy and dignity was respected. Compliments had been received and complaints were dealt with appropriately. Staff were supported to question practice and felt supported. Staff were recognised when they had worked hard and made a difference to people.

Audits were in place to assess the overall quality and safety of the service which were analysed to continually improve service delivery. Safeguarding concerns were appropriately investigated.

The services rating from their last inspection in April 2016 had been displayed conspicuously.

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

MiHomecare-Havant provides personal care services to older people, adults with disabilities and adults living with dementia in their own homes. At the time of our inspection there were 300 people receiving care and support from the service. The service had recently grown to this volume of people following the acquisition of another care company. There were 60 care staff, three field care supervisors, three co-ordinators who planned people’s care, two part time administration assistants, a regional manager and an interim manager who was applying to the Commission to become the registered manager for the service, as the current registered manager was not working at the service.

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 felt safe; however their care visits were sometimes provided later than planned or missed. As a result people did not always receive a safe service because certain aspects of their care were not provided when they required the support. Risk assessments were completed, however they were not always accurate and identified risks were not included in people’s care plans. People were at risk of not receiving their medicines safely.

Safe recruitment practices were followed and people were protected against the risk of potential abuse.

People were not always supported to eat and drink at the times they requested and this could have an effect on their well-being.

Staff did not always receive regular supervision and appraisal in line with the provider’s policy. Not all staff received an induction programme and regular on-going training.

People may be at risk of not having their views taken into consideration when care was being provided because people’s care plans did not describe what people were able to do for themselves and what care staff were required to support people with.

People may be at risk of receiving care that was not reflective of their needs because their care plans were task specific and did not contain the information highlighted on their risk assessments. Care plans did not reflect people’s preferences.

The service had not completed or returned their Provider Information Return to the Commission.

Staff did not always feel supported and felt communication between them and management could improve.

The registered manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 but did not always put this understanding into practice. We have made a recommendation for the provider to review the Mental Capacity Act 2005 and its subsequent codes of practice and ensure staff competencies are checked following training.

Mental capacity assessments were in place for people who lacked capacity. People consented to their care. People were supported to maintain good health and access on-going healthcare support.

People were involved in their care and made decisions about their care. People’s independence, privacy and dignity was respected and promoted. Compliments had been received by people and their relatives in the form of thank you cards. Complaints which had been received had been dealt with, responded to and actioned where required.

Staff were supported to question practice and notifications had been submitted to the Commission.

There were a number of audits in place which monitored the quality of the service being provided, which included surveys. An improvement action plan had been implemented to resolve the concerns with staff support and people’s care plans. People said they received a good service and had seen improvements with the service.

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