My Homecare Buckinghamshire & Oxfordshire

My Homecare Slough South Bucks is a service providing care and support to people in their own home. At the time of the inspection the service was supporting 51 people. This included both younger adults, people with physical or sensory impairments, and older people. Some people were receiving 24 hour or live-in 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.

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

We have made a recommendation in relation to person-centred care planning. Staff could speak in detail about the people they supported, with knowledge of their routines and preferences. Complaints management systems were in place and people’s care needs and satisfaction with the service were regularly reviewed.

Staff deployment aimed to provide continuity of care but we have made a recommendation in relation to staff rotas to ensure staff have sufficient travel time. People were supported by staff who were suitably inducted, trained and supported

We have made a recommendation in relation to person-centred risk assessments. People were safeguarded from risks of abuse and other risks, such as moving and handling, and infection control risks. Safe medicines administration practices were promoted, including regular audits.

Staff, people and families told us the service was well-managed. People indicated the manager of the service was accessible and staff told us they were well supported. Quality assurance systems had improved since our last inspection and the service worked well in partnership with other health and social care organisations.

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.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 6 May 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the service review their approach, so arrangements for rotas ensured the effective deployment of staff to meet people's needs. At this inspection we identified concerns about rota management and have made a further recommendation.

Why we inspected

We carried out an unannounced focused inspection of this service on 8 and 9 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for My Homecare Slough South Bucks on our website at www.cqc.org.uk.

Recommendations

We recommend the service further develop their approach to ensure staff rotas adequately consider travelling time to make sure people receive timely support. We have also made additional recommendations in relation to person-centred risk assessments and for care plans to fully explore people’s personal history, interests and aspirations.

Follow up

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

My Homecare Slough South Bucks is a service providing care and support to people in their own home. At the time of the inspection the service was supporting 72 people across Buckinghamshire, Oxfordshire and the Royal Borough of Windsor and Maidenhead. This included both younger adults, people with physical or sensory impairments, and older people. Some people were receiving live-in 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.

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

We found risks to people using the service were not always clearly identified. We also identified concerns in relation to safeguarding people from abuse, the safe management of medicines, concerns regarding staff testing for COVID-19 and a lack of auditing in relation to accidents and incidents. Most people told us they felt safe. One person explained, “I feel totally safe with the girls [staff], they are all so kind to me, nothing is a trouble, they can be a bit late sometimes and the poor things they are always in a rush to get to the next person but I am not rushed.”

People did not receive a rota to inform them of when and which staff were visiting. People’s care was added to a “route”, which the service aimed to assign regular staff. Some people told us they would like to receive a rota, and some people were not fully satisfied with staff timekeeping or their scheduled visit times. We have made a recommendation regarding staff deployment. We also received positive feedback, a relative commented, “I have no issues at all, the carers do what they are supposed to in a professional and very caring way. The carers can be a bit erratic with the times of the calls but it doesn’t really impact on [person] as I am here all the time if he needs anything.” Another relative advised, “They don’t always stay the full time but [person] is never rushed and before the carers leave they always ask if we need anything else before they go.”

Feedback was variable about whether care planning was responsive to people’s needs. We have made a recommendation regarding person centred-care planning and meeting people’s communication needs. However, we also found staff were knowledgeable about people they regularly supported. Staff provided detailed feedback about how they supported people to manage risks, how they followed people’s preferred routines, and staff were aware of what was important to people, including people’s cultural needs. We also received positive feedback in relation to the service’s support for people receiving end of life care.

People were supported by a service that was not well managed or monitored. Audits were either not conducted, or not effective to assess, monitor and drive improvement in the quality and safety of people's support. We found concerns in relation to the service’s management of complaints. We found records maintained were not always complete, accurate and kept up to date.

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 27 April 2019).

Why we inspected

We received concerns in relation to staff training and management of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for My Homecare Slough South Bucks on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches at this inspection, in relation to safe care, safeguarding people from abuse or neglect, recruitment, complaints management, governance and in informing the Commission of incidents and information they are required to.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

My Homecare Slough South Bucks is a domiciliary care agency (DCA) registered to provide personal care to people living in their own houses and flats in the Slough area. It provides a service to both younger and older adults. At the time of the inspection the agency was providing personal care and support to 21 people.

People’s experience of using this service:

• We heard feedback from people and their relatives that the service was exceptionally responsive when supporting people at the end of their lives. The service provided people with palliative care in conjunction with other professionals so that people could return to, or remain living in, their own homes when terminally ill or in a terminal condition. The registered manager and staff had the values and commitment to provide high quality care in this area of their service.

• People told us they received caring and kind support. Staff knew what was important to people and ensured people had care that met their needs and choices. People's dignity, confidentiality and privacy were respected and independence was promoted.

• People told us they felt safe with the staff. There was sufficient safely recruited staff. People received their medicines safely and as prescribed. Risks to people's well-being were assessed, recorded and updated when people's circumstances changed. The staff ensured any lessons learnt were reflected on to improve the service delivery.

• People received support that met their needs and was in line with care plans and good practice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were encouraged to maintain good diet and access health services when required.

• The service was well run by the registered manager who was supported by a team of committed staff. The provider's quality assurance processes were effective and there was a focus on continuous improvement. Where an area for improvement had been identified there was a prompt action taken to address it.

• People, staff and relatives were involved and felt listened to. The service worked well in partnership with other agencies, social and health professionals and external organisations.

Rating at last inspection: This was My Homecare Slough and South Bucks first inspection since registering with the Care Quality Commission.

Why we inspected: This was a scheduled and planned inspection.

Follow up: We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

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