Mk Hospital@Home

Mk Hospital@Home is a domiciliary care service providing personal care to older and younger adults who may have dementia, a physical disability, sensory impairment, or a mental health condition living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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 37 people were receiving personal care.

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

The systems and processes used for the recruitment of staff were not safe. The required checks of suitability to work with vulnerable people had not always been completed sufficiently to ensure fit and proper persons were employed. Risks associated with people’s needs were not always identified or accurately assessed. Records about managing risks were not always completed or shared with staff.

Accident and incidents had not always been documented appropriately; therefore, we could not see what or if actions had been taken to protect people. Medicines Administration Records (MARS) were not completed correctly so we could not be certain medicines had been given safely or correctly. Medicine audits and checks had not been effective in identifying these concerns. We were assured about IPC practices. People and their relatives told us they felt the service they received was safe.

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 their families told us they had been involved in care planning and reviews of their care. Referrals were made to other healthcare services where necessary. People were supported with their dietary and nutritional needs as they preferred. Training records demonstrated relevant training was provided. People and their relatives told us they thought the care they received was very good and spoke very positively about the staff who supported them.

Care and support plans generally provided guidance for staff on how to meet people's needs and minimise some risks. People told us their care plans had been reviewed. However, records we viewed showed some changes in needs were not always recognised or recorded in a timely way. Actions had been taken promptly to respond to any complaints.

People, their relatives and staff were consulted in the running of the service. A recent survey about the quality of the service had been completed but was not sufficiently analysed to show how the service could improve. Some regular audits had been undertaken. However, these were not effective or robust enough in highlighting the concerns we found with recruitment, records for managing risks and medicines.

The leadership in the service commenced working immediately on the shortfalls identified during the inspection and people's experiences appear not to have been impacted by those shortfalls identified.

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 20 February 2023)

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risks. This inspection examined those risks.

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

The provider took immediate action during the inspection to address some of the shortfalls we found.

Enforcement

We have identified breaches in relation to assessing and recording risks, the management of medicines, recruitment processes and the oversight of the safety and quality of the service.

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.

Mk Hospital@Home provides personal care to people in their own homes. The service is based in Kendal and provides support to people in Kendal, South Lakeland and Furness. Not everyone who used the service received personal care. CQC only inspects where people receive a regulated activity. 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 our inspection 20 people were receiving personal care.

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

People were safe and protected from abuse and harm. There were enough staff, with the appropriate skills, to support people. People received the support they needed to take their medicines. Staff knew how to protect people from infection. The registered manager had systems to learn from incidents to ensure people were safe.

The registered manager carried out a thorough assessment of people’s needs to ensure the service could provide the support people required. Staff received the training and support they needed to provide good care to people. Staff supported people, as they needed, with preparing and enjoying their meals and drinks. People made decisions about their care and their rights were protected. 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.

Staff were kind, caring and respectful to people. They helped people to feel at ease when providing their care. People liked the staff who supported them. Staff asked people for their views about their care and respected the decisions people made. Staff respected people’s privacy and dignity and promoted their independence.

The service was responsive to people’s needs and wishes. People could request changes to their care, and these were agreed where possible. People received person-centred care which met their needs. The provider had a procedure for receiving and responding to complaints about the service.

People valued the support they received and said they would recommend the service. The registered manager had developed a positive, person-centred culture. The registered manager and staff understood their responsibilities under the duty of candour and were open and honest with people when incidents occurred. The registered manager asked people for their views about their care and used their feedback to further improve the service.

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

Rating at last inspection

This service was registered with us on 31 August 2022 and this is the first inspection.

Why we inspected

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

Follow up

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