We carried out a review of the data available to us about Main office on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Main office, you can give feedback on this service.
Main Office is a domiciliary care agency which provides care and support to people living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help relating to personal hygiene and eating. Where they do, we consider any wider social care provided. At the time of the inspection 31 people were receiving personal care.
People’s experience of using this service and what we found
People and their relatives were positive about the quality of care and support they received. They told us they felt safe using the service.
People were supported by staff who had been recruited safely. They told us they received support from regular care staff who arrived on time. They said they did not feel rushed. People were protected from the risks of abuse and discrimination by staff who had been trained to recognise the signs of abuse and knew how to raise any concerns. The registered manager reported incidents to CQC and the local authority in line with guidance.
Risks to people’s safety were assessed, managed and reviewed. Risk assessments covered areas of people’s health as well as any potential environmental risks. People received their medicines safely and as prescribed. Staff were trained in medicines management and their competency was regularly assessed to make sure they continued to follow best practice.
There were clear processes in place to ensure people were protected from the risks of infection. Staff completed infection prevention and control training and spoke with us about the importance of wearing personal protective equipment (PPE) correctly. Staff had access to PPE and followed national guidance regarding the COVID-19 pandemic.
People’s care and support needs were discussed with them and tailored to meet their individual needs. Care plans were regularly assessed and updated as needed to make sure staff had up to date guidance to follow.
People knew how to complain and were confident, if they had a concern, these would be addressed. When the service received complaints and compliments from people, these were shared with staff.
People and their relatives felt the service was well-led. The registered manager led by example and monitored the quality and safety of the service. People, relatives, health care professionals and staff were asked to provide feedback to enable the registered manager to continue to drive improvements.
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 14 August 2019).
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 carried out an announced comprehensive inspection of this service on 17, 18 and 23 July 2019. 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 safe care and treatment and good governance.
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.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. 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 Main office 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.
Main Office is a domiciliary care agency which provides care and support to people living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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 the inspection 50 people were receiving personal care. An application to change the name of the service to Help at Home (Medway) was in progress with the Care Quality Commission. People and staff referred to the service in this way and throughout the report we use Help at Home as the name of the service.
People’s experience of using this service and what we found
Risks to people were not consistently assessed, identified, monitored and reviewed. There was not enough information for staff about how to reduce risks to people’s health and safety. Quality checks and audits were not consistently effective and robust and had not identified some of the shortfalls we found during the inspection. Care plans lacked holistic, person-centred information. There was little information about people’s likes, dislikes, preferences and the things and people that were important to them. The records did not reflect the care and support people told us they received, and staff said they provided. We have made a recommendation about person-centred care planning.
People said they felt safe having staff from Help at Home supporting them. People were protected from the risks of abuse and discrimination by staff who were trained to recognise the signs and knew how to report concerns. There were enough staff to support people and they had been safely recruited. People received their medicines safely and on time and were encouraged to manage their own medicines safely.
People’s health care needs were assessed and regularly reviewed. Care plans were kept up to date with any changes in people’s requirements. People were supported by a team of staff who were skilled and knowledgeable. Staff completed regular training and met with the provider for one to one supervision to discuss their personal development. People were encouraged to have a healthy and balanced diet and to drink enough. Staff worked with health care professionals, such as community nurses and the local enablement team, to make sure people remained as healthy as possible. 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 told us the staff were kind, caring and patient. One person said, “They are all very good and very kind”. People were encouraged to remain as independent as possible. People were involved in the planning, managing and reviewing of their support. They told us they felt in control of any decision making about their support. People told us staff were respectful and their privacy and dignity were maintained.
People knew how to complain but did not have any complaints about the service they received. The provider addressed any minor issues as soon as they arose and resolved them satisfactorily. The provider worked collaboratively with the staff team and shared their visions for the service. There was an open and transparent culture where people and staff were valued. People told us they thought Help at Home was a good service and that it was well-led.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 18/07/2018 and this is the first inspection.
Why we inspected
This was a planned inspection based on our current inspection programme.
Enforcement
We have identified breaches in relation to the lack of detail in risk assessments, quality checks were not always effective and there was inconsistent holistic, person-centred information in the care records at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.