Archived: My Homecare Reading

Updated 27 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector. An Expert by Experience made phone calls to people who use the service and/or relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. A second inspector made phone calls to staff working at the service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. The provider had employed a new manager however they were not able to support the nominated individual and us during inspection.

Notice of inspection

This inspection was announced.

We gave the service 48 hours’ notice of the inspection to be sure that the provider would be in the office to support the inspection. Inspection activity started on 20 June 2022 and ended on 21 June 2022. We visited the location’s office on 20 June 2022.

What we did before the inspection

Prior to the inspection we looked at all the information we had collected since the last inspection about the service including previous inspection reports and notifications the previous registered manager had sent us. A notification is information about important events which the service is required to tell us about by law. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke to the nominated individual during the inspection. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We sought feedback from people who use the service and relatives. We also spoke to five staff about their experience of work and the care provided. We reviewed a range of records relating to the management of the service, for example, records of medicine management, risk assessments, accidents and incidents; quality assurance system; and complaints/compliments records. We looked at five people's care and support plan and associated records. We looked at seven staff files in relation to recruitment.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at further records and evidence including quality assurance, training data, and policies and procedures.

Updated 27 July 2022

About the service

My Homecare Reading is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to people who have dementia, learning disabilities or autistic spectrum disorder, mental health, physical disability and older people.

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 our inspection the service was providing personal care to eight people.

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

The provider did not operate effective quality assurance systems to oversee the service. These systems did not identify shortfalls in the quality and safety of the service or ensure that expected standards were met.

The provider did not ensure consistent actions were taken to reduce risks to people and plans were not in place to minimise those risks. Effective recruitment processes were not in place to ensure, as far as possible, that people were protected from staff being employed who were not suitable. The management of medicines was not always safe. Staff did not always follow correct infection prevention and control processes when visiting people. Not all staff were up to date with, or had received, their competency checks and mandatory training. We did not have evidence the management team kept their knowledge and competencies checked and up to date. Staff did not have regular supervision and appraisals, and team meetings.

When incidents or accidents happened, it was not always clear that it was fully investigated, and if any lessons were learnt. The provider did not follow and accurately record and keep a copy of all the actions taken as required in the duty of candour regulation when a notifiable safety incident occurred. The registered person did not ensure that clear and consistent records were kept for people who use the service and the service management. The registered person did not inform us about notifiable incidents in a timely manner. Staffing levels did not always support people to stay safe and well. The provider scheduled the visits however timings and length of visits varied. People and relatives told us the times of visits were not kept according to the care plan. People and relatives gave us mixed feedback about staff being kind, caring and respectful. They did not always uphold people's privacy or respond in a way that maintained people's dignity.

People, their families and other people that mattered were involved in the planning of their care. However, the care plans did not contain information specific to people’s needs and how to manage any conditions they had. Staff did not have detailed guidance for them to follow when supporting people with complex needs. Staff were not always following the care plan to provide the right support to people.

The provider did not ensure their safeguarding systems were operated effectively to investigate and follow the provider's procedure after becoming aware of an allegation of abuse. Most of the staff were not up to date with their safeguarding training. Not all people and relatives felt they could approach the management or staff with any concerns and felt that communication had to be improved.

We judged people were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

Most of the staff members felt staffing levels were sufficient to do their job safely and effectively. The provider appreciated staff contributions and efforts during the COVID-19 pandemic to ensure people received the care and support. Staff felt they could approach the management team for support and advice. The provider was working with the local authority to make improvements.

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 15 August 2018).

Why we inspected

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

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 in relation to quality assurance; risk management; notification of incidents; safeguarding; record keeping; effective and person-centred care planning; management of medicine; infection control and prevention; staff training, competence and deployment, and recruitment. 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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. 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.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.