Background to this inspection
Updated
7 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of one Inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced.
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 22 October 2019 and ended on the same date.
What we did before the inspection
We reviewed information we had received about the service since the last inspection.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all of this information to plan our inspection.
During the inspection
We called 18 people who used the service and spoke about their experience of the care provided. We spoke with six members of staff including the registered manager, deputy manager, senior care workers, care workers and care coordinator.
We reviewed a range of records. This included three people’s care records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
7 November 2019
About the service
Millie’s Care and Support Agency Ltd is a domiciliary care service providing personal and nursing care to 95 people aged 65 and over at the time of the inspection.
Millie’s Care and Support Agency Ltd provide care and support to people living in their own homes, in Bath and the surrounding areas. Their head office is located in Bath.
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.
People’s experience of using this service and what we found
People were supported by staff who were kind and caring. People told us they felt the staff who visited them were like friends or family. When receiving personal care, people’s dignity and privacy was protected by staff, for example using a towel to cover the person.
People and staff spoke positively about the provider and the registered manager. Staff told us they were proud to work for Millie’s Care and Support Agency Ltd. People had the opportunity to voice their opinions about the service in different ways; for example, during reviews and by telephone. Notifications were sent to the commission in line with requirements. The registered manager was aware of their responsibility to act in an open and transparent way.
People told us they felt comfortable to complain but had not needed to and that the service was flexible and would re-arrange visits to meet individual needs. The provider had received one complaint in the twelve months before our inspection which was dealt with appropriately. People were helped to avoid social isolation because they were supported to access the community and people were provided with regular care staff.
Care plans reflected the needs, preferences and choices of people. The provider identified that end of life care planning was an area for development. However, relatives of people who received end of life support from the provider spoke positively about their experiences. Staff told us they received support and training to ensure they could carry out their roles. People told us they were supported to eat and drink sufficient quantities. 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 told us they felt safe and we found they were protected from the potential risk of avoidable harm and abuse. Risk assessments included guidance for staff about how to lower the risk of harm to people. Staff spoke confidently about identifying and reporting potential abuse. Medicines and creams were managed safely. We have made one recommendation in relation to the recruitment of staff. This was because two of the three staff files we reviewed did not include information about the staff member’s full employment history.
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 April 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor the service and may inspect sooner if required.