MiHomecare Kensington and Chelsea

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.

About the service:

MiHomecare Kensington and Chelsea is a domiciliary care agency which provides personal care and support to people living in their own homes. 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. At the time of our inspection 127 people were receiving personal care support.

People’s experience of using this service

Right Support: Most people told us they felt safe. The provider had made many improvements to the standards of risk assessments and care plans since the last inspection. However, despite many improvements we identified risk assessments continued to contain some conflicting information about risks. Medicines were managed safely but further improvements were also required to ensure all medicines risks were known by staff. The provider continued to follow safe recruitment processes.

Right Care: People’s experience of care had improved, however, some people continued to tell us they did not get their care visits at regular times. There were systems and processes in place to gather feedback about people’s experience of care however, people were not asked about their experience of visit times so the provider had not identified this as an ongoing issue.

Right Culture: There were quality assurance processes in place but these were not always effective as they had not resolved all the issues we found with risk assessments, medicines and the inconsistent times of care visits. Staff told us they were supported by senior staff to enable them to carry out their role. The provider was working well with external partners and other professionals.

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

At the last inspection, the service was rated as requires improvement (Report published 7 November 2022) and there were breaches of regulation. Although we found improvements had been made further improvements were required and the service remains requires improvement.

Why we inspected

We undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and whether the provider had made the improvements set out in their action plan. At this inspection we found the provider had made many improvements to safety but further improvements were required with care records and quality assurance processes.

This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service remains Requires Improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for MiHomecare Kensington and Chelsea on our website at www.cqc.org.uk.

Enforcement:

We have identified a continued breach in relation to good governance. We have sent the provider a Regulation (3) letter in relation to their ongoing failure to operate systems and processes to assess, monitor and improve the quality and safety of the services provided. A regulation 17 (3) letter stipulates the improvements needed to meet the breaches of regulation, seeks an action plan explaining what the provider will do to make improvements.

Follow up:

We will meet with the provider to discuss how they will implement their action plan and make the required changes to ensure they improve their rating to at least good. We will work alongside the provider and local authority to monitor progress. If we receive any concerning information we may return to inspect.

MiHomecare Kensington and Chelsea is a domiciliary care agency which provides personal care and support to people living in their own homes. 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. At the time of our inspection 106 people were receiving personal care support.

People’s experience of using this service

People were not always safe. The service had experienced issues with late and missed care visits which meant people were exposed to harm by not getting their visits as planned. Medicines were not always managed safely. We found conflicting information in people’s care plans about the level of support they required.

Due to the poor timekeeping and the inconsistent staff people did not feel safe. We received comments such as, “I’m not really happy with the care. Sometimes they don’t even turn up and don’t ring. They just turn up when they feel like it and I don’t have a regular carer.”

People who received care and staff were not confident in the management of the organisation. Staff told us they did not always feel supported by their manager and they did not have enough travel time to enable them to attend to people on time. The provider’s quality assurance processed were not effective as they had not identified all the issues we found with care plans and risk assessments. The provider did not work in partnership with other professionals. The provider did not use feedback effectively to improve standards of care.

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

Rating at last inspection

At the last inspection, the service was rated as Good (Report published 4 September 2019).

Why we inspected

We received concerns in relation to missed and late care visits. As a result, we undertook a focused inspection to review the key questions of safe and well led only.

For those key questions not inspected, we used the ratings awarded at the last comprehensive 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 MiHomecare Kensington and Chelsea on our website at www.cqc.org.uk.

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 monitor the service and will take further action if needed.

We have identified breaches in relation to safety, staffing and good governance processes at this inspection. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up:

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

MiHomecare Kensington and Chelsea is a domiciliary care agency which provides personal care and support to people living in their own homes.

The service was previously registered as part of MiHomecare Central London.

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

People told us their care workers were ordinarily punctual and reliable. The provider ensured that people received their care and support from regularly assigned care workers they got to know and systems were in place to minimise the risk of missed calls. People told us they were very pleased with the approach and skills of their care staff. Comments included, “Carers usually arrive on time and telephone when they think they’ll be late” and “They are wonderful people and well trained.”

People received appropriate support to meet their nutritional and hydration needs. Risk assessments were in place to identify and mitigate risks to people’s safety and wellbeing. The management team effectively liaised with health and social care professionals if they had any concerns in relation to people’s safety and welfare. People were protected by care staff who knew how to recognise signs of abuse and were confident their line managers would respond in a prompt and professional way to their concerns. People were safely supported with their medicines by care staff with suitable training and guidance.

People were supported by care staff who received training, supervision and other support for their development. The management and supervisory team carried out regular ‘spot check’ visits at people’s homes to make sure people were being cared for safely and in line with their agreed care plans.

People informed us they were treated with kindness, compassion, dignity and respect. Care staff supported them to maintain their independence, where possible. People’s views were sought for the developing and reviewing of their care plans. Their opinions were also regularly sought by the provider in relation to the quality of their care, for example through surveys and telephone monitoring questionnaires. The provider acted on this information from people to make improvements. People knew how to make a complaint about the service and the provider appropriately responded to any concerns.

The management team had detailed systems for monitoring, auditing and improving the service. Staff told us they could easily approach their line managers for advice and they were invited to participate in meaningful activities to improve the quality of people’s lives.

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 but the recording of relevant information needed to be improved.

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

Rating at last inspection:

This was the first ratings inspection for this service. The service was previously part of Mihomecare Central London, which was rated ‘requires improvement’ in March 2018.

Why we inspected:

This was a routine first ratings inspection.

Follow up:

The service was rated 'good'. We will continue to monitor information and intelligence we receive about the

service until we return to visit as per our re-inspection guidelines. If we receive any concerning information we may inspect sooner.

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