Archived: MiHomecare Brockley

Updated 10 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection took place on 22 November and 2 December 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.

The inspection was carried out by two inspectors and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we looked at notifications the provider had sent us, information sent to us from health care professionals and feedback from members of the public.

During the inspection we spoke with 26 people, four relatives and nine care staff. We looked at 16 staff files, 16 care plans, medicine administration records, complaints file and other documents related to the management of the service. After the inspection we spoke with the registered manager and a health care professional.

Updated 10 February 2017

This inspection took place on 22 November and 2 December 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.

We last inspected the service on 20 and 23 October 2015 and found the service required improvement in each domain inspected. We made three recommendations about recording known risks and documenting accurate information.

At this inspection we followed up on the recommendations made and to see whether the registered provider had made improvements to the service. We found the service had made some improvements but had not met all the standards of the regulations.

Mihomecare Brockley is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of the inspection there were 469 people using the service.

There was a registered manager in place. 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.

People were not always protected from unsafe medicine management. The service demonstrated unsafe medicine management in relation to recording, auditing and administration of medicines. There was no evidence to confirm people received their medicines as prescribed. Systems and processes did not identify issues in a timely manner.

People did not always receive care and support from staff that acted in a person centred manner. People reported staff were using their mobile phones to make personal calls, whilst delivering care.

People did not always know how to raise their concerns and complaints. The service ensured people had a copy of the contact numbers in their homes in order to raise a concern or complaint. The service responded to complaints and lessons learned shared throughout the service.

People were protected against the risk of harm and abuse. Staff were aware of the different types of abuse and how to appropriately report their concerns. Staff received on-going safeguarding and whistleblowing training. The service submitted safeguarding notifications to CQC in a timely manner.

People were protected against identified risks. The service had developed risk assessments that identified risks, action to be taken to minimise risk and the impact of the risk on people. Staff were given clear guidelines on how to support people when faced with the risk. The service recorded incidents and accidents and where possible lessons were learned and shared with staff to minimise a reoccurrence or trend.

People received care and support from sufficient numbers of safely recruited staff to meet their needs. Staff underwent robust recruitment checks including, Disclosure and Barring Services [DBS] checks, two references and interviews prior to gaining employment. People’s consent to care and treatment was sought prior to care being delivered. People’s decisions were respected.

People received support from staff that underwent all mandatory training to meet their needs. Staff were encouraged to highlight training needs and received both classroom based and E:Learning training. Staff received safeguarding, medicine management, moving and handling and Mental Capacity Act 2005 [MCA] training. Staff were encouraged to reflect on their working practices through frequent supervisions and annual appraisals. Staff were aware of their roles and responsibilities in line with the MCA and how raise their concerns regarding people’s fluctuating capacity. The service carried out regular mental capacity assessments and shared their findings with health care professionals and relatives.

People were supported to access sufficient amounts to eat and drink that met their preferences and dietary requirements. People were encouraged to participate in the planning and execution of their meal as agreed in their care plans.

People received care planning that was person centred and tailored to their individual needs and preferences. People were encouraged to contribute to the development of their care plans which were reviewed regularly to reflect people’s changing needs. People were protected against the risk of social isolation by staff that were aware of those signs and how to report their concerns.

People received support from a registered manager that operated an open door policy whereby people, their relatives and staff could meet with her when convenient to them. The registered manager was approachable and actively encouraged partnership working with health care professionals.

The registered manager questioned the service through spot checks and quality assurance questionnaires to drive improvement. Issues identified were then actioned in a timely manner in order to reach a positive resolution.