14, 15 April 2014
During a routine inspection
We considered our inspection findings to answer questions we always ask;
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Our inspection took place over two days. On the first day we visited the agency's office. We spoke with the registered manager and two care workers. We looked at documentation such as care plans, visit schedules, policies and procedures, training records, staff records, surveys and audit material. We visited and spoke with four people who used the service in their homes and spoke with two relatives.
On the second day we spoke with eight people who used the service in telephone interviews as part of our inspection process and spoke with four care workers. This is a summary of what we found -
Is the service safe?
Risks to people's safety and welfare were identified and plans had been put in place to manage them.
The registered manager took people's needs into account and ensured that care workers with the relevant knowledge, skills and experience were scheduled to care for people. This helped to ensure that people's needs were met.
Recruitment practice was robust, two references, a full employment history and a Disclosure and Barring (DBS) check were carried out before staff were employed.
Is the service effective?
Where people lacked the capacity to consent, the provider acted in accordance with legal requirements. At the time of our inspection MiHomecare did not support anyone who lacked capacity to consent. We discussed consent and capacity with the registered manager and care workers and they were aware of their legal requirements where people did not have the capacity to consent.
People's needs were assessed and care was planned and delivered in line with their individual care plan. The registered manager said that when people were referred to the service an assessment of their needs was carried out. This helped to ensure that the agency would be appropriate for them.
Supervision records showed that staff were supervised at least every three months. We saw that the supervision session included a review of care staff practice, any concerns, training needs and feedback from people.
Is the service caring?
Care was planned and delivered in a way that was intended to ensure people's welfare and safety. Care workers were divided into teams, each team was responsible for the care of a group of people who used the agency. This helped to ensure that people received consistent care and support from a group of staff who had a good understanding of their needs. One person told us: "The carers are so polite when they visit me. They always talk me through what they are going to do and check that it is okay for them to do it" Another person who used the service said: 'Every time my carer comes she always asks if I'm happy for her to help me get dressed. Sometimes I just like to stay in my dressing gown'.
Is the service responsive?
There were arrangements in place for dealing with foreseeable emergencies. There was written guidance for staff to follow if there was no reply at a persons' address, or what action should be taken in the event of an accident. The provider also had a severe weather emergency plan which outlined how people who used the service would receive care in such an event.
Is the service well led?
Records we examined showed us that the provider's quality and performance manager had carried out an internal audit of the service in March 2014. This included complaints, incidents and accidents, health and safety issues and a review of care worker files. It also included feedback from a sample of four people who used the service. Questions asked for example were, attitude of care workers, punctuality of care workers, general willingness and helpfulness of care workers and consistency of care workers.