You are here

Archived: MiHomecare - Woodingdean Requires improvement

Reports


Inspection carried out on 20 March 2017

During a routine inspection

he inspection took place on 20 March 2017 and was announced.

MiHomecare – Woodingdean is a domiciliary care service based in Brighton and is part of a large corporate provider, MiHomecare. The service supports adults and people who are living with dementia or other conditions, to enable them to continue living in their own homes. Some people privately funded their care whilst others had their care funded by the local authority. At the time of the inspection 126 people were using the service, 120 of those were in receipt of the regulated activity of personal care.

The service had 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.

We carried out an announced comprehensive inspection on 16 March 2015. A breach of legal requirements was found and the service received a rating of requires improvement. We found inconsistencies in the systems in place to manage, monitor and improve the care and support provided to people, this included significant concerns in relation to on-going incidents of late and missed calls. Following the inspection the provider wrote to us to say what they would do in relation to the concerns found. On 25 July 2016 we carried out another announced, comprehensive inspection to check that they had followed their plan and to confirm that they were meeting legal requirements. At that inspection there was a continuing breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, with regard to the monitoring, management and improvement of missed and late calls which were found to be frequent and on-going. We found breaches of legal requirements and the service received a rating of requires improvement. Another announced, comprehensive inspection took place on 20 March 2017, it was evident that improvements had been made and the provider was no longer in breach of the Regulations. However, there were areas of practice in need of further improvement and those that had been implemented were required to be sustained and embedded in practice.

Quality assurance processes had improved and there was more oversight of the systems and processes to ensure that people were receiving a service they had a right to expect. However, daily records and medicine records for people had not been audited in a timely manner to assure the registered manager that people were receiving their medicines and care on time and in accordance with their care plan and medication prescribing guidelines.

Improvements had been made since the previous inspection with regard to people being able to choose if they received care form a male or female member of staff. However, peoples’ preferences had not always been respected due to staff sickness and at times people had received care from a male member of staff rather than their preferred female member of staff.

People told us that they felt safe. One person told us, “Oh yes I feel safe with them”. Staff had received induction training and had access to on-going training to ensure their knowledge was current and that they had the relevant skills to meet peoples’ needs. People were safeguarded from harm. Staff had received training in safeguarding adults at risk, they were aware of the policies and procedures in place in relation to safeguarding and knew how to raise concerns.

There were sufficient staff to meet peoples’ needs and people told us that staff were kind and caring. One person told us, “The carers are very polite and kind. I can’t speak highly enough of them, everyone has been so kind”. People confirmed that they were treated with respect and dignity and their privacy maintained.

Risk assessments had been undertaken and were regularly reviewed. They co

Inspection carried out on 25 July 2016

During a routine inspection

The inspection took place on 25 July and was announced. MiHomecare – Woodingdean is a domiciliary care service based in Brighton and East Sussex.The service provides support and personal care to people in their own homes and covers the Brighton and Hove, Eastbourne and Seaford areas. At the time of the inspection the service were supporting 198 people with a variety of health and social needs in their own homes.

The service was last inspected on 16 March 2015. We found one breach of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 where there were inconsistencies in the systems in place to manage, monitor and improve the quality of support provided to people in their own homes, which included some significant concerns regarding on-going incidents of late or missed calls. This was identified as a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the provider was asked to submit an action plan to address this.

We reviewed the systems in place to monitor, manage and improve the quality of support provided to people as part of this inspection. At this inspection we found that while some improvements had been made to services delivered in the Brighton and Hove area the monitoring and management of missed and late calls was not consistent. We also found that the systems and processes in place for the Eastbourne and Seaford areas were not sufficiently robust and there were significant concerns regarding on-going incidents of missed and late calls in the Eastbourne and Seaford areas.

The service had 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.’

Ten people and two relatives told us that they had experienced late or missed calls. One relative told us that their family member had missed meals and medication as a result of missed calls and another two relatives told us how late called had resulted in people taking their medicines later than prescribed. This meant that since the last inspection any improvements to the systems and processes had not consistently improved the experience of people and the provider continued to have a lack of oversight of the incidents of missed and late calls. This was identified as a continuing breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff were trained to give medicines and their competency was checked prior to giving medicines to people in their own homes. However, medication was not always given at the time it had been prescribed due to late or missed calls and this was identified as a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Recruitment practices were not always robust. Two members of staff did not have full employment histories and one member of staff did not have a health declaration on file. In addition agency profiles did not confirm pre-employment checks. This meant that the provider had not ensured that staff were suitable to work with people and this was identified as a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People said they could request a male or female carer but that their preference was not always respected. One relative told us that male care workers were often allocated their family member when they had expressed a preference for female carers only. The relative had complained to the registered manager but the agreed action plan had not been adhered to. This meant that people’s preferences were not always taken into account when staff were allocated to calls and has been identified as breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Inspection carried out on 16 March 2015

During a routine inspection

MiHomecare is a domiciliary care agency based in Brighton. The agency is registered to provide personal care for people in their own home and covers the Brighton and Hove area. At the time of our inspection the agency provided a service to 124 older people, who received care and support in their own home. We carried out this inspection on 16 March 2015.

A registered manager was in post. 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.

There were inconsistencies in the systems in place to manage, monitor and improve the care and support provided to people in their own homes, which included some significant concerns regarding ongoing incidents of late or missed calls. This represented a breach of regulations and was an area that required improvement.

People spoke positively about the service they received. They told us they were well cared for and felt comfortable and safe and were happy with the staff who provided their support. One person told us “Everything’s fine. The carers turn up on time and give me all the help I need.” Another person told us “I like them; they’re kind, friendly and polite.”

Staff were appropriately recruited, trained and supported. They had all undergone an induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication had improved and regular meetings had been reinstated to discuss issues and share best practice. Staff understood their individual roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

The provider had detailed policies and procedures relating to medicine management. Staffs’ understanding and competency regarding medicine handling was subject to regular monitoring checks and medicine training was updated appropriately.

Staff knew the people they were supporting and provided a personalised service. Individual care plans, based on a full assessment of need, were in place which detailed how people wished to be supported. This ensured that personal care was provided in a structured and consistent manner. Risk assessments were also in place that effectively identified and managed potential risks.

Systems had been introduced that monitored the safety and quality of the service and gathered the views and experiences of people and their relatives. The service was flexible and responded positively to any issues or concerns raised and the manager was made aware of any concerns or complaints received. People and their relatives told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.

A breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was identified in respect of the monitoring of services. You can see what action we told the provider to take at the back of this report.

Inspection carried out on 18 February 2014

During a routine inspection

During our inspection we spoke with fifteen people who used the service, two relatives of people who used the service, a project manager who was also acting as the interim branch manager and seven staff members including a co-ordinator, two field care supervisors and four care workers.

The manager told us that since the previous inspection the service had been taken over by MiHomecare. They told us that despite the previous manager and several office staff leaving, continuity of care had been maintained, individual support had been provided for all staff and the impact on people who used the service had been minimal. This was confirmed through discussions with staff and people who used the service.

.

People told us that they received the care and support they required to meet their needs. They also told us that the care they received was generally consistent and met their individual needs. One person said �They are the best carers, very good people and so kind. If I ask them to do something they will.�

We found that systems and processes were in place to protect people from abuse. Staff knew what constituted abuse and what to do if it was suspected.

We reviewed the recruitment procedures that were in place and found that processes were thorough and well documented. Staff received regular training and supervision and felt valued and supported.

The service had effective systems in place to deal with people's comments and complaints.

Inspection carried out on 27 November 2012

During a routine inspection

We spoke with six people who used the services provided by Enara Community Care. Everyone told us they were happy with the reliability of the staff. People told us they had the same care workers visit them most of the time. The agency kept them informed if there were any delays to their call or if different staff were visiting. One person told us, �The carers treat my wife and myself like we are their mum and dad. They are lovely. They go above and beyond what we expect.�

People told us they were treated with dignity and respect and they felt safe being cared for by the staff from the agency. They also told us that staff asked permission to provide their care and they had good practical and communication skills to support them.

We spoke with three care workers and one office based employee. They told us how much they loved their job and how everyone worked well as a team. They told us they felt supported in their role through regular access to training, observation and supervision of their work. One care worker told us, �It�s a rewarding job and I feel like I�m making a difference to people�s lives.�

We found that the services provided were supported by up-to-date and comprehensive policies and procedures. Records were regularly audited and reviewed. People who used the service were asked for their views annually. All incidents, complaints and commendations about the service were logged and there was a positive culture of learning from feedback.

Inspection carried out on 21 November 2011

During an inspection in response to concerns

We were told that, in accordance with their identified wishes and individual support plans, people are encouraged and enabled, as far as practicable, to make choices about their daily lives.

We received feedback from the Local Authority that commissions services for people through the agency.

They told us of concerns, over recent months, regarding missed calls and the potential risk for people living in their own home.

However they confirmed that the agency had responded positively and had now implemented a computerised call monitoring system, which had significantly improved the situation.

Local Authority managers who we spoke with also acknowledged the cooperation shown by the agency and the willingness of the registered manager to address identified shortfalls:

�The agency has always responded immediately to any concerns we have raised. We have found the manager to be open and very cooperative with us. She has always been keen to work in partnership, in the best interests of people receiving a service�.