Archived: Careinmyhome

Updated 26 May 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was undertaken by three inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service did not have a manager registered with the Care Quality Commission. Once a manager is registered, this means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A new manager had commenced employment with the service in March 2021 and intended to register with CQC.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and we wanted to ensure there was someone in the office to speak with us. Two inspectors met with the provider and two members of the management team at the office on 15 March 2021. One inspector undertook telephone calls with people to obtain their feedback about the service. The inspection started on 11 March and ended on 24 March 2021.

What we did before the inspection

We reviewed information we had received about the service which included concerns raised. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people, including some relatives, who used the service. We spoke with six care staff, the provider, a director of the company, the manager, and three whistle-blowers. A whistle-blower is a person, usually an employee or ex-employee, who exposes information or activity about an organisation that is deemed unsafe, for example. We reviewed a range of records including ten care records. A variety of records relating to the management of the service, including policies, recruitment and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We requested additional information including risk assessments, staff training and supervision, and quality assurance records.

Updated 26 May 2021

About the service

Careinmyhome is a service providing personal care to approximately 26 people with a range of health and support needs at the time of the inspection. 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

People were not always protected from harm. Risks to people had not been adequately assessed to ensure people received safe care and treatment. The provider had not ensured all staff had the skills and knowledge to provide care safely. Infection prevention and control systems were sufficient to protect people, although one of the provider’s policies relating to Covid-19 contained information that was not in line with current government guidance. New staff were recruited safely.

Care records were held electronically. When people started to use the service, some staff needed to call the office to obtain more information about people’s care and support needs. Some staff had not completed all the necessary training. For example, no staff had undertaken training on catheter care, and some people used catheters. After the inspection, the provider arranged for staff to receive this training. There were gaps in some care plans which provided inconsistent information about people's care and support to enable staff to be aware of and fully meet their needs.

People were aware that there had been recent changes in the management team. At the time of the inspection, the Worthing office was closed due to staff having to self-isolate, so calls were put through to one of the provider’s other offices. Systems to monitor and measure the service were not effective, nor sufficiently robust to drive improvement.

People felt involved in decisions about their care and that staff would always check with them before undertaking any personal care. People confirmed that staff assisted them to maintain a healthy diet, and that if they needed any healthcare support, staff would ring the relevant healthcare professional.

People said that staff were kind and caring and that relationships with carers were good. People were treated with dignity and respect and their independence was encouraged. 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

This service was registered with us on 4 April 2019 and this is the first inspection.

Why we inspected

This inspection took place because of concerns we received. These concerns related to care plans, risk assessments, and the management of staff. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see all key questions of this full report. You can see what action we have asked the provider to take at the end of this full report.

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 providing safe care and treatment, and the overall governance and management of the service.

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.