20 & 25 August 2015
During a routine inspection
We undertook an announced inspection of MiHomecare - Okehampton on 20 and 25 August 2015. We told the provider two days before our visits that we would be coming to ensure the information we needed would be available. Mihomecare - Okehampton is a domiciliary care agency which provides personal care to people in their own homes in the Okehampton, Tavistock and Crediton areas. MiHomecare Limited has 40 domiciliary care services across the country with 29 in the South of England. At the time of our inspection between 50 and 60 people were receiving a personal care service from Mihomecare – Okehampton.
We last inspected the agency in April 2014 and found no breaches in the regulations we looked at. However, the April 2014 inspection did not include us checking the outstanding breach of the registered manager not notifying us of serious incidents. This was because of the brief timescale between the breach and that inspection. However, we were notified of serious incidents, as required, from that date.
The service is required to have 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. At the time of this inspection the manager of MiHomecare – Okehampton was completing their registration.
The arrangements and instruction for care workers about handling medicines for people were not clear and had led to medicine being administered which should not have been.
The organisation had auditing systems in place but they were not fully effective. For example, some people’s care plans, which should provide care workers with accurate information about people’s needs and wishes, were not up to date.
The visit arrangements had been reviewed and updated since an internal investigation into staff travel times. Most people felt the staffing arrangements had improved and were satisfactory. One person said, “Time keeping is getting better and most carers arrive on time now. Carers now stay for the full time”.
Care workers were clear how to protect people from abuse and there was clear information for staff on how to alert concerns.
Risks were assessed and kept under regular review. These included hazards within people’s home and the risk from falling.
Care was delivered with people’s consent. Care workers explained to people about risks to their welfare and involved family members in decisions where this was in the person’s best interest.
Care workers were complimentary about their induction and training. They were supported and supervised in their work. A district nurse said, “They’re on the ball; don’t panic, do things appropriately and follow advice.” Recruitment arrangements ensured staff had been checked before they worked in people’s homes.
Care workers showed a concern for the people they provided care and support to. People said they were treated with respect, dignity and their privacy was upheld. People’s views were sought and listened to.
People’s health, welfare and independence were maintained and promoted. People told us they could stay in their own home because of the help they received. One person said, “Because they see to my feet and legs I can still get around and go out using my walker.”
There was a current review of office arrangements by the recently appointed manager. Their emphasis was on listening to what people and staff had to say so the service could be improved. Staff said there was always somebody they could call for advice and support.
There were two breaches of regulation. You can see what action we told the provider to take at the back of the full version of the report.