Archived: MiHomecare - Live-in Hersham

Updated 21 October 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Two inspectors carried out this inspection, which took place on 4 February 2015. This visit was announced, which meant the provider and staff knew we were coming. We did this to ensure that appropriate office staff were available to speak with us and that people using the service were made aware that we may contact them to obtain their views.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make. This enabled us to ensure we were addressing any possible areas of concern and looking at the strengths of the service.

We also reviewed other information we held about the service and considered information which had been shared with us by local authorities that commission care with the provider. We looked at safeguarding alerts that had been made and notifications which had been submitted.

On the day of the inspection we spoke with the service manager and two care managers. After the inspection we contacted 24 people who used the service, 12 relatives and seven care workers.

We reviewed records at the provider’s office, including six staff files, complaints records, accident/incident records and safeguarding recording and other records related to the management of the service. We also reviewed five care plans and other relevant documentation to support our findings.

Updated 21 October 2015

We inspected MiHomecare - Live-in Hersham on 4 February 2015. This was an announced inspection as we wanted to ensure that key staff, such as the service manager, were available to speak with us. MiHomecare - Live-in Hersham is a care agency providing live-in care for people in their own homes. This includes older people, people with a physical disability and people living with dementia. At the time of our visit the service supported 111 people.

There was no registered manager in post at the time of our inspection. 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.

The last inspection of the service was carried out on 27 September 2013. At that time, the service was meeting the essential standards of quality and safety.

At this inspection, we found areas of practice that required improvement.

There were written complaints procedures in place but the provider had not satisfactorily investigated all complaints received or taken proportionate action where necessary to make improvements to the service people received.

Staff supervision and appraisal had not been taking place to ensure that staff were appropriately supported. Staff had not received training in the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards, which meant they could not be sure that the care they provided was delivered in line with this legislation.

The provider had not established an effective system to assess, monitor and improve the quality of the services provided. The service manager had identified that supervisions and appraisals had not been happening as often as they should but had not taken action to address this issue. The provider had not sought people’s views regularly to ensure that the quality and safety of the service was monitored effectively. Some people told us that their care was not reviewed often enough to take account of changes in their needs.

People and relatives told us that they felt safe with the staff that supported them. One person told us, “I’m very happy with the way my care is provided. She knows what needs to be done and she’s very efficient.” Another person said, “I have no concerns at all, I feel very safe when she provides my care.”

People told us that care workers were caring and that they had developed positive relationships with them. They said their individual needs were met and understood by kind and caring staff. Relatives said their family members were treated with respect and dignity and had their independence promoted. One relative told us, “The care is really good, they’re very polite and respectful. My Mum likes to be independent and they help her out a lot.”

People’s needs were assessed before they received care from the agency. Assessments identified the individual support people needed and their preferences about their care. Risk assessments were carried out to ensure people were safe within their home and when they received care and support. The service had policies in place to protect people from abuse and staff knew what to do if safeguarding concerns were identified. There was evidence that the agency made referrals to the local safeguarding authority where necessary.

During the inspection we identified some breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.