Archived: My Homecare Derby

My Homecare Derby is a domiciliary care service providing support to people living in their homes. The service provides support to younger and older adults with a range of needs. At the time of the inspection, the service was providing personal care to 180 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support: People are supported to have maximum control, choice and independence through the care provided in their own homes. Information is accessible, such as ‘Easy read’ guidance and information for people if required.

Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights. Staff are had received specialist training on supporting people with a learning disability, and autistic people.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. There is a positive and inclusive culture at management level, and an awareness of best practice guidance.

The service was not consistently well managed. The management team did not work together in a collaborative manner. This impacted on the staff team, delivery and oversight of the quality of care and staff morale.

Not all staff were confident in raising concerns with the management team; however, all staff told us they would report concerns to other agencies if a person was at risk of poor or unsafe care.

Safe recruitment practices required improving to ensure the providers own systems and processes were being followed. Care plans and risk assessments did not always reflect people’s changing needs.

Staff supported people with their medicines and medicines were safely managed. People told us they felt safe with the staff supporting them and were happy with the care they received.

Feedback from people’s relatives and health professionals who worked with the provider was positive. The provider learnt from incidents and complaints and shared the learning with the staff team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 28 November 2019)

Why we inspected

We received concerns in relation to staffing, including safe recruitment, staff conduct and people receiving the full length of their allocated care visit. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for My Homecare Derby on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

My Homecare Derby is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the time of the inspection the service supported 150 people with personal care.

People’s experience of using this service and what we found

We had received information raising concerns about the safe management of COVID-19 and how people using the service were being kept safe. We wrote to the provider and asked for information around their systems and processes. We inspected the service to review records and speak with people and families using the service and staff.

We found people were protected from the risk of acquiring infections. Personal protective equipment was readily available to staff. Staff were following latest guidance; We made the registered manager aware of the latest guidance for one additional area of practice and they confirmed this had been put in place.

Rating at last inspection

The last rating for this service was Good (published 18 December 2019).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about infection control risks. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from these concerns.

Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for My Homecare Derby on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

My Homecare Derby provided care services to younger adults, older people, who maybe living with dementia, physical disability, learning disabilities or mental health needs. Personal care was provided to people living in their own homes. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of this inspection 32 people using the service received personal care.

People’s experience of using this service and what we found

Medicine systems and processes were not fully effective to ensure people received their medicines as prescribed. One person was not receiving their medicine as prescribed and there was no clear audit trail, regarding who had authorised changes to this person’s medicine.

There were processes in place for people to raise complaints and express their views and opinions about the service provided. However, complaints records did not show whether these had been resolved to the complainant's satisfaction and the action taken.

There were sufficient staff available to support people and they were safeguarded from harm, by staff who understood their responsibility in reporting any concerns. Risk assessments were undertaken to minimise risks to keep people safe.

People told us they felt safe with the care provided by staff. Staff told us they had received training in a range of areas to support them in their roles. Recruitment procedures ensured prospective staff were suitable to care for people receiving personal care in their own homes. Staff were aware of how to reduce the risk of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

When needed, people were supported to maintain their dietary requirements. Staff we spoke with were aware of who to contact in the event of an emergency.

People told us staff treated them in a caring way and respected their privacy and supported them to maintain their independence and dignity. The delivery of care was tailored to meet people's individual needs and preferences.

Systems were in place monitor the quality of the service to enable management to drive improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 14 August 2018).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The inspection took place on 29 June 2018. The inspection was announced because we wanted to make sure that management were available to conduct the inspection. The nominated individual stated that seven people were using the service at the time of the inspection.

A registered manager was in post. This is a condition of the registration of 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 and associated Regulations about how the service is run.

Call times had not always been timely to respond to people’s needs.

Management had carried out some audits in order to check that the service was meeting people's needs and to ensure people were provided with a quality service, though whether people received their calls on time and not yet been audited.

Staff recruitment checks were in place to protect people from receiving personal care from unsuitable staff. Risk assessments were carried out to protect people from risks to their health and welfare.

People and relatives thought staff provided safe personal care. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area. Policies set out that when a safeguarding incident occurred management needed to take appropriate action by referring to the relevant safeguarding agency. The nominated individual was aware these incidents, if they occurred, needed to be reported to us, as legally required.

Medicines had been prompted or supplied so that people could take their medicine safely and on time, to their health needs, and records evidenced this had happened.

Staff had received training to ensure they had skills and knowledge to meet people's needs.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives. Staff were aware to ask people’s consent when they provided personal care. A system to determine people’s capacity was not yet in place so any restrictions on choice in people’s best interest had not been formally consulted on.

People and relatives told us that staff were friendly, kind, positive and caring. They said they had been involved in making decisions about how and what personal care was needed to meet any identified needs.

Care plans were individual to the people using the service, which helped to ensure that their needs were met.

People and relatives were confident that any concerns they had would be properly followed up. They were satisfied with how the service was run.

Staff members said they had been fully supported in their work by the management of the service.