Archived: MiHomecare - Carlshalton Beeches

During the inspection we reviewed eight people's care files, spoke with four people using the service and members of staff. We also reviewed records relating to people using the service, staff and management of the service.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. There were policies and procedures in place to minimise the risk of people being abused and staff knew the action to take if they suspected a person using the service was at risk of abuse. We saw confirmation that all staff had received training in the main principles of the Mental Capacity Act.

However, we were concerned that people's needs were not adequately assessed and care and treatment was not appropriately planned to ensure people's safety. Risk assessments were conducted but where risks were identified, there were no plans in place to manage the risk. We found that people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained.

Is the service caring?

We spoke with four people who use the service about the staff who cared for them and the quality of care. People said the staff were caring but some were dissatisfied with the way their care was organised. One person told us, 'It has definitely improved recently. The carers know what they are doing and do their best but I don't get a phone call if they are going to be late and that can be inconvenient." Other comments we received included, "The carers are very good"

The majority of people we spoke with told us there had been more contact with the service recently. They told us their views were obtained in a variety of ways including feedback questionnaires, announced visits and telephone calls.

Staff we spoke with were all experienced carers who told us they enjoyed caring for people using the service. Staff were adequately supported to provide care and support through relevant training, supervision and professional development. People we spoke with felt staff had the necessary skills and experience to do their job.

Is the service effective?

People's care needs were assessed and reviewed but we found the assessments and reviews were inadequate. People's care plans were not personalised and did not always reflect their preferences or current needs. One person told us, "They came recently to carry out a review but they just seemed to change over the papers. My condition has deteriorated but they didn't ask me about that at all." Another person who had a particular health condition told us "They (the service) don't seem to have taken that in to consideration and I have to keep reminding them." We found there was a risk of people receiving care which did not meet their needs.

Is the service responsive?

People who use the service, their representatives and staff were asked for their views about their care and treatment. We found that where people gave their views, they were acted on. One person told us that changes were made to the way their care was delivered after they made a complaint. We saw evidence that people's care needs had been re-assessed based on their feedback. However, people did not know how to contact the service outside of office hours in the event of an emergency. This meant there was a risk to people's health and safety in the event of an emergency.

The staff rotas were not always sufficiently flexible to meet people's individual care needs. One person told us, 'They do what I need them to do but sometimes I feel they are working to their schedule not mine." This view was supported by other people we spoke to.

Is the service well-led?

The service had a new registered manager. Several new systems had been implemented which had improved the management of the service since our last inspection. Management met regularly with staff and staff were appropriately trained and supported. Senior staff had regular contact with people using the service and took their feedback into account. However, there were still areas of the service which required improvement including how people's needs were assessed and reviewed, care planning and record keeping.

We found the service was not meeting the essential standards of quality and safety in relation to the care and welfare of people using the service and their personal records. The provider must send CQC a report that says what action they are going to take to meet these essential standards.

We found that people's needs were not assessed and people's care plans and risk assessments were not regularly reviewed. Where there were risk assessments, the risk assessments were inadequate. People were not protected from the risk of abuse because the provider had not taken reasonable steps to protect people from abuse.

There was an effective recruitment process in place and appropriate checks were carried out before staff began to work with people using the service. However, we were concerned that people were not cared for by staff who were supported by the provider to deliver care and treatment safely and to an appropriate standard.

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive. We found that some people's care records including their medical records were disorganised, out of date and inadequate.

People expressed their views and were involved in making decisions about their care and treatment. People who use the service were given appropriate information and support regarding their care and support. Their care records showed that their needs had been assessed by the agency's staff and care plans drawn up accordingly.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The manager confirmed that people's needs were re-assessed when there were changes.

We were told that all staff had regular supervision which allowed them to have protected time with a senior staff member to discuss their performance and any individual training needs that they might have.

People were complimentary about their usual care workers.