Archived: Mihomecare - Shepherds Bush

Updated 9 July 2016

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.

This inspection took place on 12 and 13 May 2016. The first day of our inspection was unannounced. We let the registered manager know that we would be returning the following day to complete our inspection.

Before the inspection we reviewed the information we held about the service. We considered information which had been shared with us by the local authority and reviewed safeguarding alerts which had been made. We looked at information we hold about the service including correspondence from the provider and complaints from members of the public.

We carried out this inspection at the provider’s office in Shepherds Bush. We spoke to the registered manager, a care manager, a field care supervisor, two administration staff and one member of care staff. We reviewed the care records of 17 people using the service. We looked at seven staff recruitment files, supervision and training records, and spoke with the registered manager about the systems in place for monitoring the quality of care people received. We looked at a variety of the provider’s policies such as those relating to safeguarding, medicines, complaints and quality assurance.

Following our visit we made phone calls to 27 people using the service and their relatives. We spoke with a further seven members of care staff by phone. We contacted two members of the local authority safeguarding team to get their views on the service. We used this feedback to help us inform our report.

Updated 9 July 2016

We carried out this inspection on 12 and 13 May 2016. The first day of the inspection was unannounced. This was our first visit to MiHomecare Shepherds Bush since the service registered at its new location in January 2016. MiHomecare Shepherds Bush is registered to provide personal care to people living in their own homes in the London boroughs of Hammersmith and Fulham and Kensington and Chelsea. At the time of our inspection 472 people were being supported by the service.

The service had a registered manager. 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 service is growing in terms of hours provided and staff recruitment is ongoing. The registered manager and the referring agencies are aware that systems, policies and procedures need to be established and embedded into practice to ensure the continuous delivery of safe and appropriate support to people living in their own homes.

The service received the majority of its referrals from health and social care professionals working in the local community. This information was used to inform and develop care plans in consultation with people and their family members (where appropriate). This ensured people’s support needs could be identified and risk assessments completed before staff began working with people. Not all care plans had been signed and dated by relevant parties to demonstrate that people were in agreement.

Where staff were responsible for prompting people’s medicines, staff had completed training in medicines administration. However, effective systems were not yet established to ensure the administration of medicines was always recorded in a safe and consistent way and monitored for potential errors or omissions.

Staff had a good understanding of safeguarding procedures and what steps they would take if someone was at risk of abuse or harm. Despite this, the provider was not always notifying the Care Quality Commission (CQC) of serious safeguarding incidents which should have been reported to us in line with the provider’s registration requirements.

People felt able to make a complaint if they needed to and knew how to do so. Staff were aware of their responsibilities regarding reporting any complaints, accidents and/or incidents and systems were in place to record these.

People’s risk assessments covered a range of issues including personal care, falls prevention and mobility. For example; information included details about how people mobilised and whether they required walking aids, the support of another person or were independent. However, not all risk assessments had been completed in full, dated or signed by relevant parties.

CQC monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff we spoke with understood what the MCA is designed to do and were able to describe how they supported people to make decisions. The registered manager was aware of the principles of the MCA and how this might affect the care they provided to people. People had their capacity assessed and they were asked (where appropriate) to provide their consent to the support being provided.

People and their family members were able to tell us about the care and support they received. Some people were living with illness associated with advancing age or other long-term health related conditions. Some people lived reasonably independent lives but required support to maintain their independence.

When required, staff supported people to make appointments and attend health appointments. There were protocols in place to respond to any medical emergencies or significant changes in a person’s health and well-being. People’s health was monitored and when it was necessary, health care professionals were involved to ensure people remained as healthy as possible.

Most of the people we spoke with expressed positive views about the care staff. People felt safe and were supported by staff who knew how to keep them safe. People were treated with dignity and respect and provided with care that was responsive to their changing needs.

Staff were aware of people’s specific dietary needs and preferences and people received the level of support they required to have enough to eat and drink.

There were arrangements in place to assess and monitor the quality and effectiveness of the service. The provider sought feedback from people using the service and staff on a regular basis; this included surveys, staff team meetings and spot checks carried out by field care supervisors.

People using the service and staff were supported by a registered manager who was committed to providing a high quality service that met people’s needs. The provider had robust policies and procedures in place for the recruitment of new staff. Staff had clear roles and responsibilities and the knowledge and skills to care for people effectively.

We identified a breach of the regulations in regards to notifications and made one recommendation in relation to medicines management. You can see the action we have told the provider to take at the back of the full version of the report.