Archived: Mi Care Southern Limited

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.

The agency 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.

The leadership and management of Mi Care Southern Limited were excellent. The ethos of service was to provide high quality and person-centred support to people. These values were owned by management and care staff alike and were underpinned by every system and practice in place. Staff were well trained and highly supported and this enabled them to deliver the best possible care to people.

People repeatedly praised the kindness of staff, with one person encapsulating this by describing their care workers as, “A daily friend.” In the feedback we obtained during the course of this inspection, we were given numerous examples of times when staff had gone above and beyond people’s expectations to provide truly personalised care.

The office staff worked hard to match suitable and regular care workers to people in order to facilitate consistent and person centred care. Management and care staff had a good understanding of people’s needs and wishes and consistently went the extra mile to communicate with and support them effectively. People and their relatives recognised and appreciated these efforts which allowed them to receive their support in a way that made them feel safe and in control. One relative told us, “Mi Care have been sensational…..I can rely on them without having to worry whilst I work.”

People were protected by the robust recruitment systems in place which ensured only suitable people were employed to support them. The registered manager was committed to only accepting new care packages where she was confident that the service had sufficient care workers with the right skills to care for them appropriately. As such people told us that the agency had never missed a call and that their care workers usually arrived on time and always stayed for the entire time allocated.

All levels of the agency demonstrated a strong commitment to providing a personalised and holistic service. The registered manager had excellent and sustained relationships with other professionals and worked alongside them to deliver the best possible care to people. A local district nurse described the service as, “A brilliant agency” and described the steps taken by Mi care Southern Limited to provide end of life care with absolute dignity and compassion. Similarly, a social care practitioner told us, “I am always relieved when Mi Care are able to take on one of my clients as I know they will receive excellent support.”

The service had good systems in place to ensure that people’s needs were properly assessed at the start and kept under ongoing review. People and their relative’s described how responsive staff had been to their needs and how, “Nothing is ever too much trouble for them.” People told us how they felt fully involved in their care and care workers talked to us about the things they did to support people to be as independent as possible. The service had good measures in place to protect people from harm. Risks to the health, safety and well-being of people were addressed in an enabling and proportionate way to ensure that people were kept safe without being restricted from living their life as they wanted.

The service celebrated its successes as a way of motivating staff, but was never complacent and always striving to continually improve. People were regularly asked to provide feedback on the service. Where people made suggestions or raised issues, they were listened to and resulted in change.

We found that people had been asked for their consent before their care had been provided.

People's needs had been assessed with them and their preferences with regards to how they wanted their care to be provided had been documented. People had consistency with the carers that provided their care.

There were procedures in place in relation to the management of medicines and it had been documented whether staff prompted people with medicines or administered them.

Staff had received an induction and on-going supervision and training.

There were processes in place to monitor the quality of the service people received.

Details of the complaints system had been provided to people.

We obtained people's views by reading surveys and the complaints recorded during the last year, and by talking to people who used the service or their families. We saw that reviews of people's care were undertaken at least twice a year. Senior staff when visiting people in their homes to carry out spot checks on care staff had also recorded people's comments.

People we spoke with commented; "The care staff have been absolutely brilliant, and we can't thank them enough', "My relative is delighted with the care staff and says the person she usually has is so helpful and hard working," and "It is a great peace of mind for me to know the staff the way I do, they are so reliable, they still came out even in the bad weather.'

The agency had a robust recruitment procedure in place; this means that people are cared for by people who have been checked to work with vulnerable people.

They also had systems in place to monitor the quality of the care they provide to individuals.