About the service May's Homecare Limited is a domiciliary care agency that provides care and support to people in their own home. People receiving a service included those with dementia, mental health, physical disabilities and learning disabilities. 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 visit the service was providing personal care to 6 people in the boroughs of Harringay and Enfield.
People’s experience of using this service and what we found
We identified shortfalls related to the running of the service. Governance of the service was ineffective and the provider did not have systems and processes in place to monitor service delivery effectively. This was needed to ensure the care was provided effectively, safely and in line with the current national guidelines.
The shortfalls we identified related to the lack of adequate assessment of risks to people’s health and wellbeing and risks associated with delivering care. Further shortfalls concerned unsafe management of medicines, recruitment procedures, working alongside external health and care professionals, the lack of personalised care planning, and limited managerial oversight of the service.
However, relatives spoke positively about the care provided and thought the care staff were kind and caring.
People were not always supported to have maximum choice and control of their lives and we were not assured that staff always supported people in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Staff asked for people’s permission before providing care, however where the consent for care was signed by people’s relatives, there was no evidence to show that these relatives had the legal right to give such consent.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service partially demonstrated how they were meeting the underpinning principles of Right support, right care, and the right culture.
Right support:
We could not always ascertain if the care provided was fully person-centred as people’s care plans lacked personalised information on people’s care needs and how they liked to receive care. Based on the feedback from people and relatives staff promoted people’s dignity, privacy and human rights when providing care.
Right care:
People, their relatives and staff told us when providing care, staff maximised people’s choice, control and independence.
Right culture:
The ethos, values, attitudes and behaviours of leaders did not always ensure people
using services lead confident, inclusive and empowered lives. The managers did not have enough oversight of all the safety concerns and risks related to the running of the service and providing safe care.
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)
This service was registered with us on 22 July 2020 and this is the first inspection.
Why we inspected
We inspected May's Homecare Limited as part of our inspection prioritisation programme. We carried this inspection as we had not inspected this location since it was registered with us in July 2020. We needed to carry out a comprehensive inspection to take an in-depth and holistic view across the whole service, looking at all five key questions to consider if the service is safe, effective, caring, responsive and well-led.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive 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.
Enforcement
We have identified breaches in relation to providing safe care, staffing, need for consent, person -centred care and the governance at this inspection. We made two recommendations about handling people’s money and recruitment.
We issued the warning notice about Regulation 17 (Good governance). Please see the action we have told the provider to take at the end of this report.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.