Background to this inspection
Updated
14 July 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 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 announced inspection took place on 14 and 19 May 2015. Forty eight hours’ notice of the inspection was given to ensure the manager and the office supporting staff would be present.
Before the inspection, the provider completed 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 plan to make.
The inspection was undertaken by two inspectors. Before the inspection we reviewed information we held about the service. This included previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law. We also reviewed information we had received from health care professionals, the local authority safeguarding team and people who had raised concerns about the service.
Prior to the inspection we sent out 41 questionnaires to people who were supported by Mihomecare and received 16 responses. We also sent two questionnaires to community professionals and received one response. We used the information obtained in the responses to inform lines of enquiry during the inspection process.
During the inspection we spoke with 14 people who were supported in their home by Mihomecare, four relatives, the regional manager, the branch manager and 14 members of staff. We also spoke with one social care professional, a community care worker, who had supported people who used the service. We carried out four visits to people’s homes and observed how staff interacted with people.
We looked at seven records related to people’s individual care needs. We viewed four staff recruitment files, training records for all staff and records associated with the management of the service including quality audits.
Updated
14 July 2015
The inspection took place on 14 and 19 May 2015 and was announced. At our last inspection on 15, 16, 17 and 22 September 2014 we found breaches of legal requirements related to the assessing and monitoring the quality of service provision and sufficient numbers of suitably qualified, skilled and experienced staff. The provider produced an action plan which explained how they would address the breaches of regulations. At this inspection we found these actions had been completed and improvements had been made.
Mihomecare Plymouth provides domiciliary care services to adults within the Plymouth area. On the day of the inspection Mihomecare was providing support to 266 people. Mihomecare provides a home care service to meet people’s needs including physical disability, sensory impairments and mental health needs including people living with dementia.
The service did not have a registered manager in post. 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 manager in post had applied to become the registered manager for the service and was awaiting the outcome of their application.
On the day of the inspection staff within the office were relaxed, there was a calming and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were clear, easy to follow and comprehensive.
People all spoke positively about the service they received, one person said “The carers have been a great help to me over the past few weeks. I have not been well at all and they have really supported me with what I need. I would have been in a right fix without them”. Another stated: “I used to be a carer myself, so I know how well they care for me. I have fantastic carers who make it possible for me to live in my own home”.
People told us they felt safe. All staff had undertaken training on safeguarding adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.
People told us staff provided consistent personalised care and support. Care records gave people control. Staff responded quickly to people’s change in needs. People and those who matter to them were involved in identifying their needs and how they would like to be supported. People’s preferences were sought and respected.
People where appropriate were supported to maintain a healthy balanced diet.
Staff described the management to be very open, supportive and approachable. Staff talked about their jobs in a strong positive manner. Comments included, “The management take an active interest, make themselves available and offer good support”, “I do very much enjoy my job” and “I get sent text messages saying thank you, that makes me feel valued”.
People’s risks were managed well and monitored. There was a culture of learning from mistakes. Accidents and incidents were managed promptly, and were appropriately recorded and analysed. Investigations were thorough. There were effective quality assurance systems in place. Action was taken to address areas where improvements were needed, and as a result, changes had been made to drive the service forward.
People had their medicines managed safely. People were supported to maintain good health. Referrals were made quickly to healthcare professionals, such as GPs, physiotherapists and occupational therapists when people’s needs changed.
People knew how to raise concerns and make complaints. People told us concerns raised had been dealt with promptly and satisfactorily. Any complaints made were thoroughly investigated, recorded and fed back in line with Mihomecare’s own policy.