Archived: Mi Care Southern Limited

Updated 29 December 2018

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.

The inspection was prompted in part by concerns raised with CQC and the local authority about care calls not being fulfilled as planned and shortfalls in communication with people, relatives and staff. There was an ongoing large scale enquiry being conducted by the safeguarding team and CQC had been receiving regular action plans from the provider. This inspection was to check the progress of improvements made through this process.

This inspection took place on 10 and 11 October 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and office staff are often out of the office supporting staff or providing care. We needed to be sure that they would be in and wanted to talk with the new management team to assess their progress against their improvement plan.

We conducted telephone interviews with people and relatives on 10 October 2018. The inspection site visit activity took place on 11 October 2018. It included reviews of records, interviews with management, office staff and care staff.

The inspection was carried out by two inspectors.

Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. We asked for feedback from the local authority.

Due to the inspection being brought forward, we did not ask the provider to submit a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

As part of the inspection we spoke with six people and two relatives. We spoke with the regional manager, the regional director, two care co-ordinators and three care staff. We looked at care plans for six people including risk assessments daily notes. We also checked medicines records for five people.

We looked at a variety of recently introduced checks and audits as well as records of surveys and minutes of meetings of staff, people and relatives. We looked at five staff files and checked records of staff training and supervision.

Updated 29 December 2018

This inspection took place on 10 and 11 October 2018 and was announced. Our last inspection was in January 2016 where we rated the service Outstanding. There had been changes in management and the ownership of the service since this time. This inspection took place in response to concerns raised about staff punctuality and responses to incidents. We found that areas of outstanding practice had not been sustained and we found breaches of the legal requirements in relation to medicines, risk management and record keeping.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.

Not everyone using Mi Care Southern Limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, 63 people were receiving personal care.

There was not a registered manager in post. The registered manager had recently left and the regional manager was providing management support at the service. 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.

Shortfalls in record keeping meant people did not always receive their medicines safely. Staff did not always maintain accurate records relating to people’s medicines. In some instances, records relating to risk were incomplete and lacked detail. Despite people’s feedback reflecting that they received person centred care, records relating to care planning lacked person-centred information. The provider was in the process of addressing concerns with staff punctuality and call attendance. However, at the time of inspection there was no system in place to proactively monitor attendance of care calls.

People spoke highly of the staff that supported them. People said staff were kind and respectful and provided them with dignified care. Staff knew people well because they regularly supported the same people. People told us that the care they received was personalised and in most instances care planned reflected what was important to people. Staff had previously received the training for their roles and work was underway to ensure training and supervision was up to date.

Staff prepared food for people that they liked. Before people received a service, staff carried out an assessment of their needs and this information was added to care plans. Where people had specific healthcare needs, staff provided support to meet them. Where any accidents or incidents occurred, staff identified actions to prevent them from happening again. Where there had been concerns with how incidents were reported and responded to, we found improvements had been made in this area. There was a complaints policy in place and the provider handled people’s complaints in line with this.

People’s consent was sought before staff provided care and people told us staff were respectful of their privacy and dignity when supporting them in their homes. People said communication had improved and the regional manager had made contact with everyone. Systems were in place to involve people and their relatives in the running of the service. Staff told us they had noted recent improvements and felt supported by management.