Inmind community Support Services Limited

Inmind Community Support Services is a domiciliary care service providing personal care for people living in their own homes. At the time of the inspection 14 people were receiving personal care from the service.

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

Since our last inspection, a number of care and office staff had left at very short notice which resulted in the provider contacting the local authority to arrange for packages of care to be transferred to other care providers. Responsibility was left with the registered manager to fulfil the responsibilities of the vacant office posts. This resulted in a lack of effectiveness in the governance of the service as the registered manager took on additional duties to ensure people’s care needs were met.

Systems were not in place to effectively monitor call delivery times. This resulted in some people experiencing early, late or short calls. Care records did not always hold the most up to date information regarding people and their care needs. People and relatives raised concerns regarding poor communication with the service.

Staff felt supported by the registered manager but had not received regular supervision or had their competencies assessed for some time.

There was no evidence the provider had actively sought feedback from people who used the service to help them monitor and improve the quality and safety of the service, and make changes in response to people’s feedback.

People felt safe when supported by staff in their own home . They were supported by a consistent group of staff who had been recruited safely and were aware of their care needs.

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.

Staff were aware of the latest government guidance regarding infection prevention control and had access to plentiful supplies of personal protective equipment (PPE.)

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 26 July 2021).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and the timings of calls. A decision was made for us to inspect and examine those risks.

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 Inmind Community Support Services Limited on our website at www.cqc.org.uk.

Enforcement

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 good governance at this inspection.

At our last inspection of the service in June 2021, it was agreed the provider could apply to have the conditions on their registration removed, as enough improvement had been seen in the governance of the service. However, the provider continued to submit monthly reports and did not apply to remove those conditions. At this inspection, we were not assured regarding the effectiveness of the governance systems in place. We therefore advised the provider that a decision has been made to keep the conditions in place to obtain assurances that governance systems would be improved. The provider will continue to submit monthly reports to provide evidence of this.

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

Follow up

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

Inmind community Support Services Limited is a domiciliary care service providing personal care for people living in their own homes. At the time of the inspection 89 people were receiving personal care from the service.

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

The provider completed audits to monitor the quality of the service. Some of the newly implemented audit processes had only been in place for five months and required more time to become embedded into working practices to maintain the improvements being made.

People's support needs were assessed to ensure they received the support they required. Staff had received training in safeguarding practices and knew how to keep people safe from the risk of abuse. Recruitment processes were in place to make sure staff employed by the provider were suitable to work with people safely. Medication was administered safely. Staff were provided with sufficient amounts of personal protective equipment (PPE) to mitigate the risk of cross infection. Processes were in place to investigate and learn from any incidents.

Risks to people had been identified and assessed. Staff had received appropriate training to support people safely. Staff supported people with their nutrition when required. The provider worked effectively with health and social care agencies.

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.

People were supported by kind and caring staff. People were treated with dignity and respect and supported to maintain their independence.

People’s care and support needs were reviewed. People and their relatives knew how to raise a complaint. Information for people could be provided in different formats.

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.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. Feedback and records showed people experienced choice and control over their support and care planning was person centred.

Right support:

• Model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

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 requires improvement (published 08 October 2019) and there were multiple breaches of regulation. 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.

Why we inspected

We received concerns in relation to the safe use of restraint when supporting people and the number of safeguarding incidents. As a result, we initially undertook a focused inspection to review the key questions of safe and well-led only. Please see the safe and well led sections of this full report.

We found no evidence during this inspection people were at risk of harm from these concerns, and as the service had made improvements, it was agreed to review all key questions.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Inmind community Support Services Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inmind community Support Services Limited is a domiciliary care service providing personal care for people living in their own homes. At the time of inspection 81 people were receiving personal care from the service.

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

People did not always receive safe care and support. We identified a breach of the regulations due to concerns about how some people’s risks, including medicines support were managed. Risk assessments were not always in place or lacked guidance for staff to follow. Where lessons could be learned to improve the service and make the care people received safer; these were not always identified and addressed. Medicine records were not always completed correctly or clearly, and monitoring systems had not identified this. Staff understood safeguarding procedures and had been recruited safely. People and their relatives told us they felt safe and that there were enough staff to meet their needs.

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. Staff had received some training but further training was needed. Staff felt supported by the management of the service. Additional training was needed for some staff regarding people’s specific needs. People told us they enjoyed their meals and they chose what they preferred. People were supported to meet their health care needs, when necessary.

The provider’s systems had not ensured the service was fully caring as people’s risks had not been managed well and people’s care plans did not always contain current information about people’s care needs. Most people told us they felt well supported by the staff who came to provide care and that they were kind and caring but we also received some negative comments about staff. People were involved in their reviews and were supported to make choices about their care.

The provider had not ensured that people’s care records contained up to date information about people’s current care needs. Whilst people told us, and we saw that reviews had taken place, they had not been wholly effective in identifying inaccuracies or omissions in people’s care records. There was a complaints procedure in place which people were aware of. We received mixed views about the provider’s response to concerns and complaints.

The governance of the service continued to need improvement and as such the quality and the safety of the service had not been effectively monitored. Our previous inspection had identified improvements were needed in relation to care records and risk assessments. This inspection identified improvements were still needed.

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 20 August 2018)

Why we inspected

The inspection was prompted in part by notification of a specific incident, following which a person using the service died. This incident is subject to an investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of choking. This inspection examined those risks.

We have found evidence that the provider needs to make improvements. Please see the ‘Is the service Safe?’ sections of this full report.

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

Enforcement

We have identified breaches in relation to keeping people safe and monitoring the care provided at this inspection.

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 continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Inmind community Support Services Limited on our website at www.cqc.org.uk.

Inmind Community Support Services Limited is registered to provide personal care services to people in their own homes. This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and younger disabled adults. CQC does not regulate premises where people lived; this inspection looked at people's personal care and support.

On the day of the inspection there were 72 people receiving support. There was a registered manager in post. 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.

People were supported by care staff trained to keep them safe. There were enough care staff to support people timely and where people needed support with their medicines this was done as it was prescribed. Care staff had the appropriate equipment to ensure people were supported safe from infection.

Care staff received the skills, knowledge and support to meet people’s needs. People were able to make choices and decisions about the support they received. The provider ensured they adhered to the principles of the Mental Capacity Act (2005).

People were supported by care staff who were compassionate and trustworthy. The provider ensured people were involved in the assessment of their needs and the support planning process. People’s privacy, dignity and independence was respected by care staff that supported them.

People’s views were listened to as part of how they were supported. Where people had a complaint, they were able to have their complaints dealt with appropriately and in a timely manner.

While the provider carried out spot checks they were not always consistently effective in identifying areas for improvement. Care records were not always clear and accurate enough to ensure care staff could support people consistently.

The provider ensured people were able to share their views on the service by completing a survey, however the outcome was not being shared with people.