MiHomecare Kensington and Chelsea

Updated 30 November 2023

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection Team

The inspection was carried out by 2 inspectors and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care 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 a registered manager in post.

Notice of inspection

Inspection activity started with calls to people receiving care and their representatives on 3, 4 and 5 July 2023. We also received a range of documents related to the management of the service and quality assurance on 20 July 2023 in preparation of the site visit which took place on 7 September 2023.” We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We looked at information we held about the service. This included details about incidents the provider must notify us about, such as allegations of abuse and serious accidents and incidents. We also reviewed all other information sent to us from other stakeholders, for example the local authority and members of the public.

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 took this into account when we inspected the service and made the judgements in this report.

During the inspection

We reviewed 10 people’s care and medicine records. We analysed electronic call monitoring (ECM) data for all people. We looked at 7 staff files in relation to recruitment and supervision. We also looked at policies and procedures and records related to the management of the service. We spoke with 20 people receiving care and 2 relatives. During the visit to the office we spoke with the registered manager and the regional head of quality. We sent feedback questionnaires to 66 care workers and we received 10 responses. We also made calls to a further 4 care workers and a care coordinator to get their feedback about the service.

Updated 30 November 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service:

MiHomecare Kensington and Chelsea is a domiciliary care agency which provides personal care and support to people living in their own homes. 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 127 people were receiving personal care support.

People’s experience of using this service

Right Support: Most people told us they felt safe. The provider had made many improvements to the standards of risk assessments and care plans since the last inspection. However, despite many improvements we identified risk assessments continued to contain some conflicting information about risks. Medicines were managed safely but further improvements were also required to ensure all medicines risks were known by staff. The provider continued to follow safe recruitment processes.

Right Care: People’s experience of care had improved, however, some people continued to tell us they did not get their care visits at regular times. There were systems and processes in place to gather feedback about people’s experience of care however, people were not asked about their experience of visit times so the provider had not identified this as an ongoing issue.

Right Culture: There were quality assurance processes in place but these were not always effective as they had not resolved all the issues we found with risk assessments, medicines and the inconsistent times of care visits. Staff told us they were supported by senior staff to enable them to carry out their role. The provider was working well with external partners and other professionals.

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

At the last inspection, the service was rated as requires improvement (Report published 7 November 2022) and there were breaches of regulation. Although we found improvements had been made further improvements were required and the service remains requires improvement.

Why we inspected

We undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and whether the provider had made the improvements set out in their action plan. At this inspection we found the provider had made many improvements to safety but further improvements were required with care records and quality assurance processes.

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 comprehensive inspection to calculate the overall rating. The overall rating for the service remains Requires Improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for MiHomecare Kensington and Chelsea on our website at www.cqc.org.uk.

Enforcement:

We have identified a continued breach in relation to good governance. We have sent the provider a Regulation (3) letter in relation to their ongoing failure to operate systems and processes to assess, monitor and improve the quality and safety of the services provided. A regulation 17 (3) letter stipulates the improvements needed to meet the breaches of regulation, seeks an action plan explaining what the provider will do to make improvements.

Follow up:

We will meet with the provider to discuss how they will implement their action plan and make the required changes to ensure they improve their rating to at least good. We will work alongside the provider and local authority to monitor progress. If we receive any concerning information we may return to inspect.