The inspection took place on 9, 10 June 2016. The inspection was announced as My Choice Homecare provides domiciliary care to people in their own homes. We gave the service 24 hours’ notice to make sure there was someone at the office for the time of our inspection. My Choice Homecare is a domiciliary care service that provides personal care and support to older people and people living with dementia. The service covers the Consett area of County Durham and at the time of our inspection the service supported 51 people.
At the time of our inspection the service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission 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.
At the time of our inspection the registered manager was unavailable due to ill health and the inspection was carried out with the deputy manager.
We spoke with care workers who told us that the registered manager and deputy manager were always approachable. We spoke with people who used the service on the day of the inspection and their relatives who also told us the registered manager and deputy manager were always supportive, accessible and open.
We looked at staff training and found that not all staff had the same amount of training and some staff had gaps in their training records.
Staff had received a recent appraisal but no regular supervisions were carried out or planned in accordance to the services policy.
We saw that people’s prescribed medicines and topical medicines were recorded when administered. We looked at how records were kept and spoke with the deputy manager about how staff were trained to administer medicines. We found that the medicine administration, recording and auditing process was safe; however the auditing system needed strengthening.
From looking at people’s support plans we saw they were person centred. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes and needs and choices are taken into account. The support plans described individual’s care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the registered manager.
People who used the service received person centred support and their individual needs were respected and valued.
Individual support plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary. For example, the mental health team, GP or care manager.
Our conversations with people who used the service and their relatives showed us that people who used the service were supported in their own homes by sufficient numbers of staff to meet their individual needs and wishes.
We looked at the recruitment process and found that relevant checks on staff took place and this process was safe. People who used the service where matched with staff according to preferences and interests as part of the recruitment process.
People where possible were encouraged to participate in activities that were personalised and meaningful to them. People were supported regularly to play an active role in their local community, which supported and empowered their independence including accessing local facilities.
We saw a compliments and complaints procedure was in place. This provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed them.
We found the service had been regularly reviewed through a range of internal audits. We saw action had been taken to improve the service or put right any issues found. We found people who used the service, their representatives and healthcare professionals were regularly asked for their views about the service via surveys.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. Any applications must be made to the Court of Protection. At the time of this inspection applications had been made to the Court of Protection and several others had gone through the process.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.