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Archived: MiHomecare - Poole Inadequate

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Inspection report

Date of Inspection: 29 September and 7, 8, 13 October 2014
Date of Publication: 9 December 2014
Inspection Report published 09 December 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 29 September 2014, 7 October 2014, 8 October 2014 and 13 October 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information sent to us by commissioners of services. We talked with commissioners of services.

Our judgement

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

Reasons for our judgement

As part of our inspection we looked at the rotas for the week commencing 29 September 2014 and 13 October 2014. We found that for the week commencing 29 September there were 90 calls to people that did not have a care worker allocated. For the week commencing 13 October, there were 46 calls without a care worker allocated.

The acting manager told us that they had problems with staffing due to sickness, staff leaving and holidays. During our time in the office the care coordinator spent almost all of their time contacting care workers to take on extra work. The acting manager, care coordinator and field care supervisor were also spending additional hours working as care workers to help ensure that all of the visits were completed.

Two of the care workers we spoke with told us that the remaining care workers were being asked to take on more work including those who were part time and those who had chosen not to opt out of the maximum 48 hours per week. The care workers we spoke with told us they were tired but were doing the extra work because they worried that otherwise people would not receive the care they needed.

Analysis of rotas also showed that there was no time allowance for care workers to travel between calls. We looked at the allocations for three staff over a period of three days. We found examples where care workers had to make numerous calls with distances of up to 5 miles between the calls but with no time in between the visits. For example, visit A was 10.00 to 10.30, visit B was 10.30 to 11.00 and there was a five mile journey between visits. All of the care workers that we spoke with told us that they always felt in a rush, and were likely to arrive late for calls or not stay for the period of time that had been agreed and paid for. We found that MiHomecare policy for Care Provision stated that "the employee must be able to get to the Service User's home easily, by whatever form of transport they use, with adequate travel time factored into their roster. This must be a minimum of five minutes for each service user they are allocated."

During our visits to people we looked at the records of visits made by the care workers. We compared the arrival times requested in care plans with actual arrival times and the length of visit as requested in the care plan with the actual time the care worker stayed.

We found that, for one of the people we visited, their care plan stated that they received four 30 minute calls a day at 08:30, 12:30, 17:30 and 19:00. We found that, of the 10 visits we looked at, only one visit lasted for 30 minutes and one visit was only five minutes. The average time that care workers stayed over these 10 visits was 17 minutes. The actual times that carers arrived varied considerably from the care plan: care workers told us that the agency policy states that it aims for care workers to arrive within 10 minutes before or after the scheduled time. We found that, of the 10 calls made, only two were within the specified times and some were up to an hour and 10 minutes late or one hour and 40 minutes early. We asked the person who received care and their relative about this. They told us that they had frequently asked that the calls were at the agreed times, especially the night time call, because the carers were coming to assist the person to bed much earlier than they wanted. They also told us that they needed the calls to be regularly spaced through the day to enable them to maintain their dignity with assistance to the toilet.They told us that the rotas had not been changed to meet their needs and preferences.

The care plan for another person we visited stated that they also should have four 30 minute calls a day. We looked at records for the previous seven days which relates to 28 calls across this period. Only 13 calls had been recorded. Again, we found that very few of the calls were lasting for the duration that was written in the care plan. Two of the calls laste