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Archived: MiHomecare - Bristol Inadequate

The provider of this service changed - see old profile

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Inspection report

Date of Inspection: 10, 15 September 2014
Date of Publication: 10 October 2014
Inspection Report published 10 October 2014 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 10 September 2014 and 15 September 2014, talked with people who use the service and talked with carers and / or family members. We talked with staff and reviewed information given to us by the provider.

Our judgement

There were not always enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

Prior to this inspection we had received information of concern that there were not always enough qualified, skilled and experienced staff to meet people’s needs.

We spoke with the regional director and the senior member of staff employed at the branch who was currently responsible for the day to day care delivery. They told us they had recently experienced an unforeseen shortage of staff and that a recruitment process was being undertaken. They explained that this, together with frequent short notice of staff sickness had presented a recent challenge and had resulted in a direct impact on the timeliness of the care people received.

We asked the senior member of staff responsible to supply us with current information relating to staffing. This information showed that in the six months previous to our inspection, 19 staff had left the service, and this included the person managing the service. The information showed that out of the 19 staff no longer employed at the service, 17 staff had resigned and two had been dismissed from employment. The information supplied from the service projected that the current staff vacancies were the branch manager, one care co-ordinator, three field care supervisors and six full time care staff. The regional director told us that in the interim, additional office based and care staff from the provider’s other services were being used as a contingency.

Insufficient staffing levels did not ensure continuity of care. We spoke with 13 people who used the service and one person’s relative. We received mixed feedback from people about the staff who provided their care. Some people told us that they received the same regular staff, however others told us they were not always aware of who would be providing their care. For example, some people we spoke with told us that when the received their weekly care planning rota to show when their appointments were, the rota did not provide them with the staff members names and only showed the word ‘relief’. This meant they were not aware of who would be providing their care until the staff member arrived.

One person’s relative told us that recently staff had arrived who they had never seen before, and that the staff member was not aware of their relatives needs and it took a significant amount of time to explain this. Another person said they had received care from ‘lots’ of different staff and two other people told us they had called the service to express their concern about the number of different staff they received care from. This meant that people who used the service may receive care in their home, including personal care such as washing and dressing, from staff members they had never met before that day.

Staff told us that although people’s care needs were met, they were not always able to stay the correct length of time with people. We spoke with 11 members of staff regarding staffing levels at the service and the impact current staffing levels had on people’s care. They all told us that although the service was currently understaffed they were able to meet people’s needs, however care appointments were often cut short to achieve this. For example, one member of staff told us that they frequently reduced appointments to ensure they could attend all of their appointments. One member of staff told us, “There is no time to chat to people anymore. I just rush the care and go.” Another staff member told us, “It’s horrendous, we are expected to do everything fast.”

Staff also told us that additional short notice appointments were given to them whilst they were on duty. Some staff we spoke with told us that despite having a set appointment schedule, they would often be called by the care co-ordinators to be informed that additional appointments had been added to their round at short notice due to staff shortage or sickness. They said that due to the care co-ordinators absence of knowledge about people’s care needs, some complex