My Homecare County Durham

My Homecare County Durham (previously known as My Homecare Durham) is a domiciliary care agency, providing personal care to children and adults in their own homes. The service also provides personal care and support to adults with learning disabilities and autistic people living in a 'supported living' setting. At the time of the inspection there were 122 people receiving personal care.

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.

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 were people using the service who have a learning disability and/or who are autistic.

Right support

People received safe care and support in their own homes. Staff received training in safeguarding and knew how to protect people from the risk of abuse. Most people and relatives were happy with the care and support provided. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff communicated with people in ways that met their needs.

Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.

People said their care calls were mostly on time and they were supported by a consistent staff team, which made them feel safe. Staff had a good understanding of people's needs and how they wished to be supported.

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.

Right care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs. Staff were recruited safely, and people received support from a small team of consistent staff wherever possible.

Staff and people co-operated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. People had good relationships with staff and were happy with the way staff supported them. Medicines were managed safely and administered by staff who had completed relevant training and were deemed competent.

Right culture

The registered manager encouraged an open and positive culture. The service was well managed and provided good quality, consistent care to people in their own homes. People were supported to be as active and independent as possible. They were encouraged to participate in activities within the service and in the local community, and to maintain contact with family and friends.

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management team and staff. The provider regularly sought feedback from people who used the service, their relatives and health and social care professionals to continually improve the service. There were effective quality monitoring systems in place.

We have made a recommendation regarding care plans.

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 8 August 2018).

Since the last inspection the provider applied to CQC to make changes to their registration, namely moving to a new office location. This inspection started whilst the service was registered at premises in Consett. During the inspection, CQC approved the provider’s application to move to an office location in Stanley, near the address where people live in a supported living setting.

Why we inspected

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

This report only covers our findings in relation to the key questions safe and well-led. 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 remains good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for My Homecare County Durham on our website at www.cqc.org.uk.

Follow up

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

This inspection took place on 18 and 19 July 2018 and was announced. We gave the provider 24 hours’ notice of the inspection to ensure we could meet with staff and speak with people using the service in their own homes.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to older adults and younger disabled adults. On the day of our inspection there were 60 people receiving the regulated activity of personal care. This was the first inspection of the service since the registration of the service changed in 2017.

Not everyone using the service receives regulated activity; The Care Quality Commission (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.

The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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. The registered manager had extensive experience of working in the social care sector.

Notifications of significant events were submitted to us in a timely manner by the registered manager.

Medicines administration was safe. This was regularly audited and staff competencies monitored by senior staff.

People were supported to take risks safely and personalised risk assessments were in place to ensure people were protected against a range of risks.

Staff had received safeguarding training and were able to describe types of abuse and what they would do to report concerns and protect people.

Staff recruitment was carried out safely with robust safety checks in place for new staff.

New staff received induction training and were accompanied and supported by dedicated mentors called ‘care coaches’ to enhance their induction and extend it if necessary.

People were supported to have choice and control over their own lives from being supported by person centred care. Person centred care is when the person is central to their support and their preferences are respected.

There were sufficient staff to meet people’s needs safely, with travel time included and supervision checks undertaken to ensure staff completed care visits as agreed.

Staff were trained in safeguarding, first aid, moving and handling, the Mental Capacity Act, infection control and food hygiene. Additional training was in place or planned in areas specific to people’s individual needs.

Staff had a good knowledge of people’s likes, dislikes, preferences, mobility and communicative needs. People we spoke with gave us positive feedback regarding staff and how their needs were met.

People were supported to maintain their independence by staff that understood and valued the importance of this.

Care plans were sufficiently detailed and person-centred, giving members of staff and external professionals relevant information when providing care to people who used the service. Care plans were reviewed regularly with the involvement of people who used the service and their relatives.

The registered manager displayed a sound understanding of capacity and the need for consent on a decision-specific basis. Consent was documented in people’s care files and people we spoke with confirmed staff asked for their consent on a day to day basis.

Health care professionals, including GP, dietitians or specialist consultants were involved in people's care as and when this was needed and staff supported people with any appointments as necessary.

Staff, people who used the service, relatives and other professionals agreed that the registered manager led the service well and was approachable and accountable. We found they had a sound knowledge of the needs of people who used the service and clear expectations of staff. They had plans in place to make further improvements to service.

A programme of audits was carried out by the registered manager and these were effective at improving the service.

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.

Infection control measures were in place for staff to protect people from the risk of infection through training, cleanliness and protective clothing where required.

People and their relatives were able to complain if they wished and were knowledgeable of how to complain or raise minor concerns.

People who used the service and their representatives were regularly asked for their views about the support through questionnaires and feedback forms.

Information was made available to people in different formats if required and a communication and accessible information policy was in place.