Background to this inspection
Updated
28 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.
The inspection took place on 7 June 2017 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service and we needed to be sure the manager would be available to meet us.
The inspection was carried out by 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.
Prior to the inspection, we looked at notifications the provider had sent us, information sent to us from health care professionals and feedback from members of the public. The registered manager also sent us a Provider Information Return (PIR). The PIR is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make. We looked at the information the provider had submitted.
During the inspection we spoke with four care staff, the registered manager and the service’s quality and performance manager. We looked at six staff files, support plans, medicine administration records, complaints file and other documents related to the management of the service. After the inspection, we spoke with seven people who used the service and ten relatives to seek their views about the service.
Updated
28 July 2017
We inspected Mi Homecare Ltd on 7 June 2017. We gave the provider 24 hours' notice of our inspection to make sure the appropriate people would be there to assist us with our inspection. Mi Homecare Limited is a domiciliary care service based in Ilford, Essex. The service provide personal care and support to approximately 120 people in their own homes. Staff support people using the service with a wide range of needs, including assistance with personal care, domestic tasks, shopping and making meals.
On the day of the inspection, the service had 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.
We received mixed responses about the service from people who use it. While some people were happy with the level of care provided, others were not.
People were at risk of receiving poor support because there was a lack of specific risk assessments. They did not give guidance to staff about how to manage and mitigate risk for people such as the use of bed rails. Support plans were not personalised and lacked detail. The service had not identified the issues we found at the time of inspection.
Detailed support plans were not in place and records were not always updated following changes in people's needs. People were supported by staff if needed, to access support from healthcare professionals where required. We found that medicines were not always administered safely by staff.
The service had systems in place to monitor the quality of the service provided through seeking people's feedback and carrying out spot checks. However, these were not sufficiently robust as they had not identified the issues we found during our inspection. An overview of where improvements were required was not undertaken in order to make improvements.
Staff received sufficient training, supervision and yearly appraisals of their work and performance. Staff had a basic understanding of the application of the Mental Capacity Act (2005). We found recruitment checks were in place to ensure new staff were suitable to work at the service. Staff had positive views about the leadership and staff culture of the service.
People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. The provider carried out checks to ensure that staff employed were of good character.
Staff were generally deployed in a way that people received care from consistent staff. People told us that they got along well with staff that knew them well.
People who used the service and their relatives told us the staff were caring. Staff respected people's privacy and dignity and encouraged them to maintain their independence.
People and their relatives knew how to make a complaint, these were satisfactorily dealt with by the management team. Staff felt supported by management and felt able to approach them with any concerns.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities)Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.