We carried out a review of the data available to us about Home Instead South Manchester on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Home Instead South Manchester, you can give feedback on this service.
Home Instead South Manchester is a domiciliary care agency providing personal care to people in their own homes. 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 inspection, 30 people were receiving personal care.
People's experience of using this service and what we found
There were issues around the safe recruitment of staff. Some pre-recruitment checks were not made in the four files we considered, and, in one case, the service could not be satisfied that a member of staff continued to be safely employed. After the inspection, additional measures were put in place to ensure these matters were resolved. We found no evidence people were at risk of harm from this concern. This has resulted in making a recommendation that can be seen in the 'safe' section of this report.
People told us they felt safe. Staff understood their responsibilities about keeping people safe. Risks were identified and managed. Incidents and accidents were recorded so that they could be considered and reflected upon to make improvements to the service. Staff understood their responsibilities to prevent the spread of infection whilst working in and between people's homes.
People liked the staff who supported them and told us staff were kind and respectful. The registered manager, provider representative and staff considered people’s diversity and respected their right to privacy and dignity. They encouraged people to be as independent as they could be and involved them in decisions about their care. The service could provide people with information about local advocacy services, to ensure they could access support to express their views if they needed to. People's personal information was kept confidentially.
Staff had completed training in key areas and were supported to carry out their roles. They were supported in their roles by the provider and registered manager. People were supported to access health services if needed. People's dietary needs were assessed and, where required, they were supported with their meals.
People's care plans were up to date and detailed their individual needs and preferences. People and their relatives knew how to complain, although none we spoke with had any complaints. One person said, "With any issues, I'd just speak to the manager and it will be sorted out without the need to raise a complaint."
The service was managed by a registered manager who had a clear vision about the quality of care they wanted to provide. Staff were aware of their roles and responsibilities. There were quality assurance systems in place to monitor the quality and safety of the service. There was a focus on continuous improvement and learning from mistakes.
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 26 July 2017).
Why we inspected
This was a planned 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.
Home Instead South Manchester is a domiciliary care service registered to provide personal care to people living in their own home. They also provide other services such as shopping, cleaning, and social support and companionship to people. Care staff employed by the service are referred to as Caregivers. Their office is located in Chorlton cum Hardy, Manchester and provides support to people living in South Manchester. At the time of our inspection the service was supporting 20 people who received the regulated activity of personal care. This was the first inspection of this service since its registration with the Care Quality Commission (CQC) in May 2015.
The service had a registered manager who had been in post since May 2017. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and relatives told us the support they received was safe. There were recruitment processes in place to help ensure suitable staff were employed. This should help to ensure people were kept safe from harm.
Staff we spoke with knew what safeguarding meant, the types of abuse and what action they would take if they suspected abuse was taking place. Records we looked at showed all staff had received safeguarding training. This meant staff had the necessary knowledge to help protect people from harm in the event abuse was suspected.
Where required, people were helped to take their medicines. No one we spoke with identified any concerns with the service’s system of administering medicines. However we noted medication errors in the accident and incident records, not all of which had been actioned appropriately. We also saw training had been delivered to help strengthen any deficiencies staff had in this area. This intervention should help to ensure staff were adequately skilled to administer medicines in a safe way.
There was a system for reporting and recording accidents and incidents that took place within the service. We noted no formal analysis of incidents had been done. This meant the provider and registered manager did not have full oversight of these incidents which could help to understand and potentially make improvements in this area.
People using the service and their relatives told us they were satisfied with the consistency of care and that they had regular care staff supporting them. This meant people were supported by staff who understood their specific care needs.
Risk assessments contained sufficient details to help staff ensure people were kept safe from harm. People told us care staff had good hygiene practices and wore personal protective equipment when carrying out their duties. This should help to ensure that people were protected from the risk of infection.
People and their relatives had confidence in the abilities of care staff. Staff had done an induction and mandatory training to prepare them to undertake their role as care givers. The registered manager told us they were developing a system of streamlining the ongoing training programme. This should help to ensure care staff were adequately trained to do their jobs effectively.
People told us care staff always asked their permission before undertaking any task. The registered manager and care staff were knowledgeable on mental capacity. When we looked at people’s care records we saw they had signed consent to care documents. The service told us where people lacked capacity to consent to care they ensured appropriate legal authority such as lasting power of attorney was in place. We noted in two people’s records these had been signed by a relative and there was no record of appropriate legal authority for this. This meant we could not be sure the appropriate authorisation was in place to help ensure decisions made on behalf of people were lawful. The nominated individual told us that this was an administrative oversight which they would ensure they looked at going forward. The service assessed people’s mental capacity regularly and there were systems in place to help ensure decisions relating to care and support were made in people’s best interest should they lack capacity to make decisions for themselves.
People told us they knew care staff would support them if they needed any medical attention. Care staff told us if they observed that people needed healthcare support they would report these concerns to the office and record them in people’s daily records. Daily records we looked at confirmed this. We were satisfied that staff were proactive in making sure people received the right health care as required.
People were supported and encouraged to make healthy eating and drinking choices. This should help people to maintain a balanced diet and support their wellbeing.
People and their relatives told us the service provided compassionate care and support. The registered manager said one of the main philosophies of the service was to develop good relationships between people and their care staff. People supported by the service confirmed they thought of their caregivers as part of the family. We saw the service had a system in place to help match people with an appropriate care staff.
People were encouraged to maintain their independence according to their abilities and staff were able to demonstrate through examples how they supported people in a way that respected their privacy and maintained dignity.
From reviewing care plans we saw people, and where necessary, their relatives had been involved in the care planning process. This meant people and relatives had the opportunity to discuss and decide the right support and care to suit their individual needs.
The service undertook an initial consultation and risk assessment prior to providing a service. This helped the service to determine if they could provide the type of care and support required. Care plans we looked at were detailed and person-centred and provided staff with adequate and specific guidance to provide care and support.
There was a complaints process in place. People we spoke with told us they had not made a complaint. We noted from minutes of a senior management meeting that a person had raised concerns and there had been discussion about this issue. However we did not see a record of how the service had dealt with this.
People and their relatives were complimentary about the care and support provided. We saw compliments had been received from people, relatives and community professionals as well.
The service produced community activity guides free of charge which featured things to do within the communities in which they supported people. We found this was a good example of community engagement.
People and their relatives told us the service was well managed and they were happy with the care and support received.
Quality assurance processes in place were not sufficiently robust and did not identify some of the issues we found at inspection. This meant that people’s care and support was not adequately monitored to ensure their safety and wellbeing.
There were adequate policies and procedures in place which should help to ensure care staff had appropriate guidance to carry out their roles effectively.
The registered manager had developed a monthly newsletter to help improve their communications with the care staff. We saw the first issue had been produced in May 2017 and looked at issues such as training and staff meetings.
Staff meetings would be held every two months and gave care staff the opportunity to discuss their jobs and any concerns they may have about their duties with the registered manager and their colleagues.
We saw evidence that the nominated individual and the service were involved in several community engagement projects within the local community. These helped to raise awareness about several issues affecting older people such as fraud prevention and dementia and could help to improve people’s quality of life.