Background to this inspection
Updated
21 July 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 23 and 24 May 2017 and was announced. We gave the provider 48 hours’ notice of the inspection. This is because the service provides personal care to people living in their own homes; we needed to be sure the registered manager and staff would be available to meet with us. 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.
As part of the inspection we reviewed the information we held about the service. We looked to see if statutory notifications had been sent by the provider. A statutory notification contains information about important events which the provider is required to send to us by law. We looked at information contained in the provider’s Provider Information Return (PIR). A PIR is a document the provider completes in advance of an inspection to share information about the service. They can advise us of areas of good practice and outline improvements needed within their service. We sought information and views from the local authority. We also reviewed information that had been sent to us by the public. We used this information to help us plan our inspection.
During the inspection we spoke with six people who used the service and nine relatives. We spoke with the registered manager, two regional managers, the deputy manager, the care coordinator and three care staff. We reviewed records relating to three people’s medicines, three people’s care records and records relating to the management of the service; including recruitment records, complaints and quality assurance records.
Updated
21 July 2017
This inspection took place on 23 and 24 May 2017 and was announced. Homebased Care (UK) Ltd is a domiciliary care service that provides personal care to people living in their own home. At the time of the inspection the service was supporting 25 people. These people were mainly older people living with dementia, health conditions or disabilities.
At our last inspection completed on 18,19 and 24 October 2016 the provider was operating this service from an address that did not form part of their registration with CQC. We found the provider was in breach of the condition of their registration around the address at which they were operating the service from. Since this inspection the provider had ensured they had made the required amendments to their registration. As a result, this location was registered in January 2017. This inspection was the first inspection since these changes to their registration were made.
At the October 2016 inspection we asked the provider to make improvements to the service they provided to people. You can read our findings in full in the inspection report published at www.cqc.org.uk. At this inspection we found significant improvements had been made although further improvements were still required.
There was a registered manager 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.
People were supported by sufficient numbers of care staff who had been recruited safely. People’s safety and well-being could at times be put at risk due to care visits not taking place at the correct time. People were happy with the support they received with their medicines although the management team could not always confirm if people had received their medicines as prescribed.
People were protected by a staff team who could describe the signs of potential abuse and knew how to report any concerns about people. Staff understood how to protect people from the risk of harm due to accidents and injury.
People were supported by care staff who received regular training and support. People who had mental capacity were supported to consent to their care. Improvements were needed to ensure the rights of people who lacked capacity were upheld in line with the Mental Capacity Act 2005.
People’s day to day health was mostly maintained by care staff and support was sought from relevant health and social care professionals. We found people’s food and fluid intake was not always sufficiently monitored where they required support in this area which exposed them to the risk of harm.
People were supported by a care team who were kind and caring in their approach. People were encouraged to make choices about the care they received. People’s dignity was upheld and they were treated with respect. People were encouraged to remain as independent as possible.
People had not always received their care visits at a time that met their needs and preferences. People were happy with the support they received from care staff when they were present but remained unhappy with the timings of their calls. People’s care plans were reviewed and updated as required.
People’s formal complaints were recorded and investigated appropriately. However, we saw informal complaints were not always recorded and people felt these were not always addressed sufficiently.
People felt improvements had been made in the service and management team in the months leading up to our inspection. People were cared for by a staff team who felt supported by management. People were experiencing an improvement in the service due to actions taken by management. However, we found quality assurance systems still needed some further development to ensure all areas of risk and improvement required were identified and addressed.
We found the provider was not meeting the regulations around the effective management of the service. You can see what action we told the provider to take at the back of the full version of the report.