Archived: MiHomecare - Mora Burnet House

Mora Burnett House is an extra care housing scheme that provides support to people in their own flats in a purpose-built block. The provider is registered to support people with personal care and there were 29 predominantly older people using the service at the time of our visit.

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

Medicines were managed safely. Since the previous focused inspection there had been changes made to improve the way that medicines were managed. We were assured that people were receiving their medicines as prescribed. Systems to manage risk and monitor the quality and safety of the service had improved and were now suitably robust. Systems to ensure enough numbers of staff were effectively deployed to meet people’s needs had improved.

People told us they trusted staff and believed that staff were caring and treated them well. The provider had a policy and procedure for safeguarding adults from abuse although no concerns about people coming to harm had been raised since our previous inspection. The manager and staff understood the principles about what behaviours constituted abuse, the types of abuse, and the signs to look for. People were protected from the risk of infection and the service had good measures in place to manage during the COVID-19 pandemic.

People and their relatives, where relevant were involved in making decisions about their care. When people had short calls, or their visit times had changed from their agreed times, there was a record of this. The recording of why these visits did not meet the expected amount of time allocated had improved since our previous inspection with some further development needed. However, people told us that staff were usually arriving when they expected them to.

The provider completed checks and audits on accidents and incidents, staff training, safeguarding and spot checks to drive improvements. The service had an on-call system to make sure staff had support outside office working hours. The manager and the provider remained committed to working in partnership with other relevant agencies to achieve positive outcomes for people.

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 requires improvement (published 6 March 2021).

Why we inspected

This inspection was carried out to assess if the warning notice we had issued about medicines management had been complied with. There had also two others been breaches of regulations involving staffing, and systems to monitor the quality and safety of the service. We can report that the warning notice and other breaches of regulation had been addressed.

This inspection considered the key questions of safe and well-led and provide a rating for those key questions.

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

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Mora Burnett House is an extra care housing scheme that provides support to people in their own flats in a purpose-built block. It provides a service to predominantly older adults. At the time of our inspection 30 people were using the service.

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

Medicines were not managed safely. We could not be assured that people were receiving their medicines as prescribed. Systems to manage risk and monitor the quality and safety of the service were not robust. Systems were not robust enough to ensure sufficient numbers of staff were effectively deployed to meet people’s needs safely.

People and their relatives gave us positive feedback about their safety and told us that staff treated them well. The provider had a policy and procedure for safeguarding adults from abuse. The manager and staff understood what abuse was, the types of abuse, and the signs to look for. People were protected from the risk of infection. The provider had a system to manage accidents and incidents to reduce the likelihood of them happening again. The manager monitored these events to identify possible learning and discussed this with staff.

People and their relatives, where relevant were involved in making decisions about their care. However, when people had short calls, or their visit times had changed from their agreed times, there was no record to suggest people had consented to it. The manager and staff understood their responsibilities under The Mental Capacity Act 2005. Staff respected people and showed an understanding of equality and diversity. People’s care plans included details about their ethnicity, preferred faith and culture. Care plans were person centred and included the level of support people needed from staff. The provider had a policy and procedure to provide end-of-life support to people.

The provider completed checks and audits on accidents and incidents, staff training, safeguarding and spot checks to drive improvements. The service had an on-call system to make sure staff had support outside office working hours. The manager and the provider remained committed to working in partnership with other relevant agencies to achieve positive outcomes for people.

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 24 June 2019).

Why we inspected

This inspection was initially carried out as part of a pilot exploring virtual approaches to inspection. However, during the course of the inspection we identified concerns with medicines management, staffing and governance. This meant that under the terms of the pilot we needed to convert the inspection to one that included a site visit. We carried out a site visit on 02 December 2020. This inspection was a mixture of a focused inspection and a targeted inspection.

This inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.

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

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to people’s medicines management, staffing, and systems to monitor the quality and safety of the service at this inspection.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Mora Burnett House is an extra care housing scheme that provides support to people in their own flats in a purpose built block. It provides a service to predominantly older adults. At the time of our inspection 33 people were using the service.

People’s experience of using this service:

The care and support provided to people was person centred. People’s care plans and risk assessments included information about their care and support needs and preferences. Care staff had the necessary guidance about the support each person required and how people preferred to be cared for. Individualised guidance for staff was also provided to assist care staff to reduce and manage any risks that people faced in receiving care. These records were reviewed regularly and updated where there were any changes in people’s needs.

Staff had received training about safeguarding and knew how to respond to, and report, any allegation or suspicion of harm or abuse. They understood the importance of reporting concerns immediately.

The service’s recruitment procedures were designed to ensure that staff were suitable for the work they would be undertaking. New staff members were not permitted to work with people until the necessary verification of employment history, references and Disclosure and Barring service checks {DBS} had been undertaken and were satisfactory.

New staff received an induction to the service before starting work. All staff received regular training to ensure that they were able to meet the needs of the people they supported. Care staff also took part in regular supervision sessions to support them in carrying out their roles.

People and their family were involved in decisions about their care. People had been involved in agreeing their care plans and participated in reviews of the care and support provided to them. People said that staff asked them before carrying out care and support tasks.

Information about people’s religious, cultural and communication needs was included in their care plans. Care staff supported people to participate in activities of their choice individually or with others also living at the service if they wished to be involved.

People were regularly asked about their views of the care and support that they received.

Processes were in place to manage and respond to complaints and concerns. People were confident about raising any complaints they may have about the service if necessary.

The provider undertook a range of audits to check on the quality of care provided. These were reviewed by the management team and actions had been taken to address any concerns.

Rating at last inspection:

This is the first inspection of the service since registration.

Why we inspected:

This was a planned comprehensive inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to inspect as part of our re-inspection programme.

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