JaMax Homecare

JaMax Homecare is a domiciliary care agency, providing personal care to people in their own homes. At the time of inspection, 26 people were using the service. 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.

People's experience of using this service and what we found.

The provider and registered manager had addressed concerns we previously identified. Care plans and risk assessments were being reviewed, and health specific care plans and risk assessments were now in place to ensure that staff had information to safely monitor need and respond to risk. Systems and processes had been put into place to improve the oversight at the service.

People and their relatives were very satisfied with the personal care staff provided. They said they were treated with respect and dignity and staff had a very caring and friendly approach to them. They said they had very good relationships with staff. Staff respected people's privacy and encouraged them to maintain their independence and do as much for themselves as they wanted to.

Timely calls were not always in place to provide people with the personal care they needed. The registered manager swiftly followed up this issue with a small number of people.

Safe recruitment practices were in place to ensure only suitable staff worked at the service.

Details of how to reduce risks to people's safety were included in people's care plans. Care plans reflected people’s individual needs. Enough staff were employed to meet people's needs. People and relatives said safe care was provided, with people protected against abuse, neglect and discrimination.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and relatives were aware of how to approach the registered manager to raise concerns or complaints. The registered manager understood their responsibilities and worked in an open and transparent way.

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

Why we inspected

The inspection was to follow up the Warning Notice and Requirement Notice we issued to the provider following the last inspection. We have found evidence that the provider has made improvements.

The overall rating for the service has improved to good based on the findings of this inspection.

Rating at last inspection

This is the 4th inspection for the service. The last inspection was in January 2023 when the service was rated requires improvement. There were breaches of Regulation 12 Safe care and treatment, and Regulation 17 Good governance, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

JaMax Homecare is a domiciliary care agency providing personal care and support 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 32 people were receiving personal care from the service.

People's experience of using this service and what we found.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there was a person using the service who had a learning disability and or who was autistic.

Not all risks in relation to people receiving personal care were assessed. People had care plans in place. However, these did not include clear information to guide staff to provide safe care and support. Some of the information, including the monitoring and impact of people's health conditions, was limited. This did not ensure staff had the required information to support people in the best possible way.

The provider had not established or operated effective systems and processes to assess, monitor and improve the quality and safety of the service. The provider's audits were not always effective in providing oversight and identifying where improvements were required. Audits and checks had not identified the issues we found at this inspection.

People felt safe with staff supporting them and staff understood their role in safeguarding people. The provider's safeguarding policy and procedure required reviewing and updating. People were supported by consistent staff who knew them well, which helped to mitigate some of the risks we found.

Systems were in place to ensure good infection prevention and control practice. However, the provider's infection prevention and control policy and procedure required reviewing and updating to reflect measures to reduce the risk of current infections, including those of COVID-19.

Staff supported people to make decisions about their care and, where possible, people had signed to consent to their care and support. Decision making processes were not always included in care plans where people had limited or fluctuating capacity. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not clearly support this practice.

People's care needs were assessed before their care package started. People and relatives were involved in developing and reviewing their care which supported staff to provide personalised care. Staff knew people well and worked positively with people's relatives and other agencies to support people to achieve good outcomes from their care.

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

Rating at last inspection

The last rating for this service was good (published 13 July 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to the assessment and management of risks and the governance of the service at this inspection.

We made a recommendation that the provider researches best practice guidance to ensure they are following the principles of the Mental Capacity Act.

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

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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, people with mental health needs, sensory impairments, and physical disabilities.

Not everyone using JaMax Homecare received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection, 40 people received personal care support.

The service had a registered manager. 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.

People were complimentary about the care provided by staff. They told us staff were kind, and caring, and undertook the agreed care and support tasks without rushing them.

People told us most of their care calls were at the time expected, and staff always stayed the agreed length of time. If care workers were delayed they were informed of this.

The risks related to people’s care were identified and acted on. People’s needs were appropriately assessed and reviewed at pre-arranged intervals or sooner if required.

Medicines were mostly managed safely, however some medicine records did not clearly inform of the medicines administered. When necessary, healthcare services were contacted to ensure people had the healthcare they required.

Where previously agreed, staff supported people to prepare or heat their meals. Some people enjoyed eating takeaway fish and chips, which staff brought to their homes on a pre-arranged basis.

Staff felt supported by management. They were given enough time to undertake their work safely and to meet people’s needs. Management had improved their record keeping and checks of the quality of work provided by staff.

People and staff both felt staff had the skills and knowledge to undertake their work. Staff had received training to support them in their role.

People felt able to complain to the management team if they had concerns. All people who completed the recent quality assurance questionnaire had been positive about the care and support provided by JaMax Homecare.

JaMax Homecare provides personal care to adults with a variety of needs living in their own homes. This includes older people, people with a sensory impairment, people with physical disabilities and people living with dementia. JaMax Homecare provided non regulated care to people, for example cleaning and shopping. At the time of the inspection there were 40 people who were receiving care that was a regulated activity.

At our last inspection carried out on 25 February 2016 we found that the provider had not met the regulations relating to good governance, and fit and proper person employed. At this inspection we found that the provider had made some of the required improvements.

The service had a registered manager. 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.

People were protected from the risk of harm at the service because staff had undertaken training to recognise and respond to safeguarding concerns. They had a good understanding about what safeguarding meant and how to report it. The registered manager had not reported one incident to the local authority that should have been reported. The provider reviewed accidents and incidents and recorded actions to try and prevent reoccurrences. Risks to people’s well-being had been identified. However, control measures were not in place to minimise the risk.

We found there were enough staff deployed to support people safely. Checks to ensure staff suitability for their role had not been completed before they started work.

People received their medicines. Staff had been trained to administer medicines. However they had not been assessed as competent to do so. The provider agreed to make sure that all medicines that were to be given were written down individually.

Staff received appropriate support through an induction and supervision. There was an on-going training programme to provide guidance and update staff on safe ways of working.

People chose their own food and drink and were supported to follow a specific diet if this was needed. Staff prompted people to contact healthcare services when required to promote their well-being.

People were asked for their consent before they were supported.

People received care from staff who they saw regularly. They felt that staff knew their likes and dislikes.

People received support from staff who showed kindness and compassion. Their dignity and privacy was protected. People felt that staff had time to spend with them and did not rush. They felt that they received care that was focused on them as an individual.

People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives.

People had been involved in reviews of their support. People had support plans that included information about their likes and dislikes. Staff knew how to support people based on their preferences and how they wanted to be supported. People were supported to be as independent as they wanted to be.

People and their relatives were asked for feedback about the service.

The provider had made changes to how they communicated with staff to ensure that they were supported in their role and that communication was more effective.

The registered manager had a system in place to review documentation. They did not complete audits to consider the quality of service that had been provided. Systems and processes that were in place were not effective at monitoring the service that had been provided or to drive improvements.

We found one continuing breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The service provided personal care to adults with a variety of needs living in their own homes. This included people living with dementia, sensory impairments, physical disabilities, older people, people with learning disabilities, and younger adults. At the time of the inspection there were 106 people using the service. The service also provided non regulated care to people, for example cleaning and shopping. JaMax Homecare provided care to 40 people who received care that was a regulated activity.

The service had a registered manager. 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.

People told us that they felt safe when staff supported them.

Risk assessments were in place which set out how to support people. The service had safeguarding and whistleblowing procedures in place. Staff were aware of their responsibilities in these areas.

People told us that staff arrived on time for appointments to support them and did not miss any calls.

The provider did not have robust recruitment procedures in place. Pre-employment checks had not always been completed before new care workers started supporting people using the service. Information about staff’s previous employment and gaps in employment had not been recorded.

People were supported to take their medicines by care workers. Staff were in the process of completing training to enable them to support people with medicines.

When people started to use the service a care plan was developed that included information about their support needs, likes, dislikes and preferences. This meant that staff had the relevant information to meet people’s needs.

People were prompted to maintain a balanced diet where they were supported with eating and drinking. People were supported to access healthcare services and staff monitored people for changes in their health and well-being.

Care workers had completed some training however they had only completed limited training. Staff had not had regular supervision meetings. Staff worked with more experienced staff members when they started work but did not complete an induction process.

We recommend that the service considers using the Care Certificate. The Care Certificate is a nationally recognised set of standards that can be used to prepare care workers for their role.

Staff told us that they sought people’s consent prior to providing their care.

Staff developed caring relationships with people and understood people’s needs and preferences.

People were involved in decisions about their support. They told us that staff treated them with respect.

People were involved in the assessment of their needs.

There was a complaints procedure in place and people felt confident to raise their concerns.

We found that quality assurance systems were not in place and audits had not been completed. The provider had not identified the shortfalls in quality that we found during this inspection. This meant that the provider was not able to ensure that people were receiving safe or effective services that met their needs.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report..