Cmichaels Healthcare

Updated 23 September 2023

The inspection

We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.

Inspection team

The inspection team consisted of 1 inspector and 1 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were 2 registered managers in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be available to support the inspection.

Inspection activity started on 26 June 2023 and ended on 28 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used information gathered as part of our Direct Monitoring Activity (DMA) which took place on 2 December 2021. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed a range of records. This included 5 people’s care records to see how their care and treatment was delivered. Other records looked at included 5 recruitment files to check suitable staff members were recruited and received suitable training. We also looked at records relating to the management of the service. We obtained the views of service users and their relatives of the services they received, by speaking with 5 service users and 4 relatives. We also spoke to 7 members of staff and 1 registered manager.

Updated 23 September 2023

About the service

CMichaels Healthcare is a domiciliary care agency registered to provide personal care to people living in their own homes. Not 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 the inspection the service supported 39 people.

People’s experience of using this service and what we found

Staff did not always have access to information to enable them to support people safely in certain circumstances. People told us that the manager was committed to good care and that staff followed guidance from families and care plans. The provider had safeguarding systems in place and staff were well-informed in how to keep people safe.

Staff were knowledgeable about infection prevention and control (IPC) and the use of personal protective equipment.

People and their relatives were given the opportunity to be involved in the assessment of needs and preferences for services provided to them. Staff received induction training. Staff supported people to prepare meals and to eat and drink. People were supported by staff to book and attend medical appointments. People received support in keeping with the principles of the Mental Capacity Act 2005 (MCA).

People had positive experiences of how they were treated and supported. People’s privacy and dignity is respected.

People and their relatives told us some staff lacked the English language skills to understand regional dialects in the United Kingdom.

The registered manager usually had oversight of the service. There a a few instances highlighted within this report of where oversight was lacking. The registered manager was open and honest with people when things went wrong.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

Rating at last inspection and update:

The last rating for this service was Inadequate (published 07 March 2023).

This service has been in Special Measures since 07 March 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

At our last inspection we recommended that the provider updates care plans with more detail and improve systems when recruiting staff. At this inspection we found significant improvement had been made, however further work is required.

The overall rating for the service has changed from Inadequate to Requires Improvement based on the findings of this inspection.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the Well Led section of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We identified a breach in relation to assessment of risks and needs at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.