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Archived: MiHomecare - Seaford Requires improvement

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Reports


Inspection carried out on 5 and 9 February 2015

During a routine inspection

MiHomecare – Seaford is a domiciliary care agency (DCA), based in Seaford. It provides personal care and support to older people living in their own homes covering a large area incorporating Eastbourne, Seaford, Lewes and Peacehaven. People receiving this care had varied care and support needs. This included help with personal washing, the administration of medicines and support in the preparation of food. Some people had memory loss and lived with dementia. Other people had mobility problems and needed assistance in moving, often with the support of two staff and equipment.

In addition the agency had a contract with the local authority to provide personal care and support to people who lived in two Extra Care Housing schemes. These provide a number of self-contained flats that were managed by a separate organisation. These developments have communal sitting areas and food was provided through a kitchen on site if wanted. People over the age of 60 years rent or buy a flat and the agency provides 24 hour contact service for extra care or emergencies. Personal support and care is available on a regular basis if people want this service. One of the schemes is located in Peacehaven and is called Downlands Court. The other is located in Uckfield and is called Margaret House.

This inspection was announced with the provider given 48 hours’ notice. The inspection took place on the 5 and 9 February 2015.

The DCA did not have a registered manager. 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. The registered provider must ensure the registered location had a registered manager in accordance with their condition of registration. The DCA had lacked leadership and clear management for the past year.

Medicines were not always managed safely. Records were not always accurate and systems did not ensure that variable dosage medicines and other prescribed medicines were given as required.

Recruitment records did not confirm the provider had assured themselves that staff working had relevant checks undertaken to ensure they were suitable to work with people at risk.

Written and verbal complaints were not always responded to in a timely and proactive way. This meant information of concern was not always used to improve the service and some complainants did not have their concerns addressed.

The management of the service did not ensure that the Statement of Purpose (SOP) had been revised and updated to reflect the current practice of the DCA as required, or that notifications were sent to the CQC in accordance with legal requirements.

The provider had not established quality monitoring systems across the service. Ways of reviewing the care and improving the care and quality of the service were not in place.

The scheduling of staff allowed for staff with the correct skills and approach, that met people’s preferences, to care for people at times that met people’s needs. People felt safe and liked the support workers who looked after them. Risk assessments were undertaken to identify and minimise risk as far as possible. Communication between people and the office staff was not always effective although feedback indicated this had improved over recent weeks.

Staff training had been reviewed and established with a training co-ordinator to schedule and monitor staff completion of essential training. Induction training was completed and all staff had either undertaken or were in the process of completing the Organisational induction programme. Staff had the opportunity to develop their skills with additional training if they wanted to. Systems for monitoring and supervision of staff were being developed, but were not in place for all staff.

People were looked after by staff who were caring and kind and took account of people’s privacy and dignity. They worked with other health and social care professionals to promote a person centred approach and as much independence for people as possible. People had their health care needs attended to with the support and guidance of additional health and social care professionals when required.

People said they were happy with the care and support staff provided to them and that it met their individual needs. However, not all care plans and assessments were completed in a consistent way. Some documents were missing from files and other information was not up to date. This may lead to staff not fully understanding the care needs of people.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we have taken at the back of the full version of the report.

Inspection carried out on 28 November 2013

During a routine inspection

During our inspection we spoke with nine 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 four staff members including a co-ordinator, a field care supervisor and two care workers.

The manager told us that since the previous inspection the service had been taken over by MiHomecare. They confirmed that the rebranding had included staff restructuring and introducing a uniform for care workers. However they told us that despite the previous manager and team leader leaving, 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.

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People told us that they received the care and support they required to meet their needs. They told us that their care and support needs had been discussed with them and the care they received reflected this.

They also told us that the care they received was consistent and met their individual needs. One person said, "I'm very happy with the care and support I get. The carers are like family to me.” Another person commented, "The carers are all excellent and I don’t want you to change them."

We looked at the systems and processes the service had 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 21 November 2012

During a routine inspection

People we spoke with were complimentary about the quality of the care and support they received. One person said the staff were “very accommodating” and they would “always make time to do everything that needed doing.” Another said ”the staff are always cheerful and have time for a chat.”

Some of the comments made by relatives in their questionnaires were “the carers are superb, cheerful and smiley,” “it’s the best domestic care I’ve ever had” and “staff dealt at all times with my father professionally and in a caring way.”

Staff we spoke with felt well supported by the manager and said that the service tried to organise rotas so that people did not have too many different care workers. We saw from staff records that they all had received mandatory training.

There were monitoring systems in place to ensure continuing high standards including client questionnaires and regular staff meetings.

Inspection carried out on 19 June 2012

During a routine inspection

The manager told us that, in accordance with their identified wishes and individual support plans, people using the service were 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 confirmed that they had recently undertaken a quality monitoring audit of Enara – Brighton, Seaford and Eastbourne.

The report concluded: ‘Overall, it is felt that the Brighton and Seaford branches of Enara are providing a good level of care to service users, and that the service delivery from the Eastbourne office, whilst not of the same quality as the other two branches is on the whole adequate’.

The main issue of concern was regarding the allocated time for care workers travelling between calls and the need for assurances that travel time be ‘more realistic and reflective of distance and time of day’.

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 to any concerns raised. We have found the manager to be open and very cooperative. She has always been keen to work in partnership, in the best interests of people receiving a service’.