5 and 9 February 2015
During a routine inspection
MiHomecare – Seaford is a domiciliary care agency (DCA), based in Seaford. It provides personal care and support to older people living in their own homes covering a large area incorporating Eastbourne, Seaford, Lewes and Peacehaven. People receiving this care had varied care and support needs. This included help with personal washing, the administration of medicines and support in the preparation of food. Some people had memory loss and lived with dementia. Other people had mobility problems and needed assistance in moving, often with the support of two staff and equipment.
In addition the agency had a contract with the local authority to provide personal care and support to people who lived in two Extra Care Housing schemes. These provide a number of self-contained flats that were managed by a separate organisation. These developments have communal sitting areas and food was provided through a kitchen on site if wanted. People over the age of 60 years rent or buy a flat and the agency provides 24 hour contact service for extra care or emergencies. Personal support and care is available on a regular basis if people want this service. One of the schemes is located in Peacehaven and is called Downlands Court. The other is located in Uckfield and is called Margaret House.
This inspection was announced with the provider given 48 hours’ notice. The inspection took place on the 5 and 9 February 2015.
The DCA did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 registered provider must ensure the registered location had a registered manager in accordance with their condition of registration. The DCA had lacked leadership and clear management for the past year.
Medicines were not always managed safely. Records were not always accurate and systems did not ensure that variable dosage medicines and other prescribed medicines were given as required.
Recruitment records did not confirm the provider had assured themselves that staff working had relevant checks undertaken to ensure they were suitable to work with people at risk.
Written and verbal complaints were not always responded to in a timely and proactive way. This meant information of concern was not always used to improve the service and some complainants did not have their concerns addressed.
The management of the service did not ensure that the Statement of Purpose (SOP) had been revised and updated to reflect the current practice of the DCA as required, or that notifications were sent to the CQC in accordance with legal requirements.
The provider had not established quality monitoring systems across the service. Ways of reviewing the care and improving the care and quality of the service were not in place.
The scheduling of staff allowed for staff with the correct skills and approach, that met people’s preferences, to care for people at times that met people’s needs. People felt safe and liked the support workers who looked after them. Risk assessments were undertaken to identify and minimise risk as far as possible. Communication between people and the office staff was not always effective although feedback indicated this had improved over recent weeks.
Staff training had been reviewed and established with a training co-ordinator to schedule and monitor staff completion of essential training. Induction training was completed and all staff had either undertaken or were in the process of completing the Organisational induction programme. Staff had the opportunity to develop their skills with additional training if they wanted to. Systems for monitoring and supervision of staff were being developed, but were not in place for all staff.
People were looked after by staff who were caring and kind and took account of people’s privacy and dignity. They worked with other health and social care professionals to promote a person centred approach and as much independence for people as possible. People had their health care needs attended to with the support and guidance of additional health and social care professionals when required.
People said they were happy with the care and support staff provided to them and that it met their individual needs. However, not all care plans and assessments were completed in a consistent way. Some documents were missing from files and other information was not up to date. This may lead to staff not fully understanding the care needs of people.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we have taken at the back of the full version of the report.