My Homecare Cambs

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We identified 2 breaches of the legal regulations. Improvements were needed to care plans, risk assessments, and medication records to ensure people always received safe care. However, the provider had systems in place for people to raise complaints and concerns. The provider had appropriate safeguarding and infection prevention and control policies, and staff had access to PPE and understood its usage. Enough staff were planned and deployed. Staff had received training and regular supervision. People and their relatives felt supported and involved in care planning. People did not raise any concerns in relation to safety.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Feedback from people and their relatives did not indicate any concerns in relation to being able to raise complaints and concerns if they needed to. People and relatives knew who the manager was and felt able to approach them.

No significant incidents or accidents had been documented. The provider was able to tell us how they would manage incidents and accidents in line with their policy.

There were systems in place for staff to report incidents and accidents. The providers policy identified the need for any lessons from accidents and incidents to be taken to inform changes to peoples care plans or working with outside professionals if needed. There was evidence that the provider had sought feedback from people and checked to see if they were happy with the care they received.

The provider told us they had worked with external professionals such as occupational therapists, doctors and consultants. The provider gave us an example of a planning meeting that took place a day before our assessment where a person’s care needs were reviewed in view of their increased care related needs. Staff had attended health appointments with people where people needed this support. The provider also told us they had been working with a consultant to ensure their service quality and meeting regulatory compliance.

During our visits, we identified and highlighted improvements needed to people's care plans, risk assessments and medicines records to promote people's safety. This is covered in more detail in other parts of the report. While the provider did respond to our feedback and make improvements, actions taken by the provider to improve safety were prompted by our assessment. This meant at the time of our assessment, the provider's systems to promote people's safety as far as reasonably practicable were not always established or operated effectively.

People and their relatives did not raise any concerns in relation to safeguarding or any other safety concerns.

The provider understood when safeguarding referrals needed to be made and who to refer them to. Although, at the time of our assessment, there had not been any safeguarding concerns related to people in receipt of regulated activity, the provider showed us examples of when they had made referrals for other people they supported.

The provider had a safeguarding policy in place. We did not identify any concerns in relation to the provider’s safeguarding processes. Staff had received safeguarding training.

People told us they felt supported and had been involved in care planning. Where people were known to communicate emotional distress or altered states of consciousness, relatives felt staff supported them well.

Overall, the provider and staff we spoke with understood the risks people could experience and knew people well. For example, the provider told us they were in the process of supporting a person to get a new bed put in a part of their home, which would improve their safety in relation to their mobility needs.

During our first visit, we found that people's care plans needed improvement to ensure accurate information and minimise risks. We identified incomplete information about people's mobility, falls risks, dietary needs, and health conditions. Although some improvements were made after our feedback, more was needed. An example was a lack of clarity in a care plan regarding modified food texture and drink and how staff should support the person if they refused modified texture foods and drinks. After giving the provider our initial assessment feedback, we invited the provider to submit evidence of improvement to us, and although some improvements were made, these resulted due to our assessment rather than the provider independently identifying and managing risks with people.

People who were in receipt of care in their own homes, or their relatives did not raise any concerns about the safety of their environments.

We did not identify any concerns from feedback from the provider or staff about the safety of their working environments.

The provider did not have an established system to check and record if all the mobility equipment they were supporting people with was serviced and safe. In response to these findings, the provider introduced a system for weekly safety checks. However, the provider completed environmental risk assessments on people’s homes to help inform whether any risks needed be managed to promote people's and staff’s safety.

People and relatives gave us positive feedback about staffing. A person told us, in relation to the staff member they saw most often, “the one thing I don’t like is when care is rushed, and [Staff Member] doesn’t rush and makes sure I’m ok. [Staff Member] knows me really well… we have a laugh, and that’s what you need and a nice, caring nature.” A relative told us the provider had made positive changes and provided staff that spoke languages they spoke for better communication. Relatives told us staff arrived on time and stayed for the full duration of their allocated care calls.

Staff told us they had completed training relevant to their roles, such as infection prevention and control and safeguarding. They confirmed they received regular supervision and felt well-supported by the provider. The provider talked us through their recruitment processes, which included written exercises ensuring staff could meet their expectations regarding documenting information.

Staff had received training relevant to their roles and people's health needs, such as safeguarding, epilepsy, diabetes, and catheter care. Staff were recruited safely. This included obtaining character references before staff commenced their roles and carrying out Disclosure and Barring Checks (DBS).

People did not raise any concerns in relation to infection prevention and control. Where people also received support with domestic tasks, no concerns were raised in relation to the quality of support they received.

Staff confirmed they always had enough access to PPE and understood when to use it. Training records showed staff had received infection prevention and control training. The provider had appropriate infection prevention and control policies in place.

People did not raise concerns to us regarding the support they received to manage medicines. One person told us staff gave them their morning medicines, but they took the rest themselves. After we gave the provider feedback, which included our concerns with medicines, the provider sent us statements from 2 people, including the person who told us staff gave them their morning medicines, which stated, "My Homecare staff have never administered my medication; the most they have done is move one box of medication from one surface to another surface in my house."

The provider's feedback about medicines management was inconsistent. During our first visit, the provider told us they prompted 1 person to take their medicines but did not give anybody else support with medicines. However, we found records that indicated staff had signed for the administration of the medicines for the person who was to be prompted. Following informing the provider of this, they spoke to the person or their relatives and arranged for them to take full responsibility for their medicines. During our following visit, we asked the provider how the person's prescribed creams were being managed, as this was applied as soon as they had been supported with their hygiene needs; the provider told us staff called for a relative to apply creams after being supported with their hygiene needs due to them no longer providing any support with medicines. We checked the person's notes for the previous 2 days and found staff had documented they had applied the person's cream and given them their medicines. We also found staff had documented they had supported other people with medicines. This meant we could not be assured of the provider's feedback about their support and involvement with people in managing their medicines.

Systems and processes for auditing medicines administration records had not always been effective. An individual's medicines administration records contained errors and lacked information, such as defining which eye their eyedrops should be administered to. The provider's medication audits had not identified these areas as needing improvement. Additionally, systems to audit people's daily records had not always been effective, as staff had documented that they supported people in receiving their medicines, but the provider had not identified this to ensure care plans were reflective and accurate of the support staff provided or to inform staff they should not be providing this support. Furthermore, statements we received via the provider signed by people were received after the provider acknowledged our concerns regarding medicines administration.