We carried out a review of the data available to us about MiHomecare Hammersmith and Fulham 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 MiHomecare Hammersmith and Fulham, you can give feedback on this service.
MiHomecare Hammersmith and Fulham is a domiciliary care agency. The service provides personal care to older people and people with physical disabilities. At the time of our inspection there were 265 people using the service.
Not everyone who used the service received personal care. In this service, the Care Quality Commission can only inspect the service received by people who get support with personal care. This includes help with tasks related to personal hygiene and eating. Where people receive such support, we also consider any wider social care provided.
People’s experience of using this service and what we found
People told us they were treated with respect and kindness by the care workers. Most people we spoke with told us that staff arrived on time and stayed for the full duration, however a number of people told us they did not know when staff were due to arrive and were sometimes late. We have made a recommendation about how the service communicates with people who use the service about what they can expect.
People told us the service contacted them to find out their views about the service, but the provider did not always effectively record or respond to feedback. The provider had identified this as an area for development and were due to implement a new system for recording feedback.
Risks to people were assessed with appropriate risk management plans, which conveyed key information about risk to staff. Sometimes risk assessments contained contradictory information which had not been noted in audits. We have made a recommendation about how the provider checks the suitability of risk management plans. Care workers received appropriate training to keep people safe and carry out tasks safely, and people’s feedback confirmed this. People received their medicines at the right times with suitable procedures to ensure this remained the case. People were safeguarded from abuse and poor treatment.
Staff told us they were well supported by managers and received appropriate training and supervision. The service passed information about changes in the branch and learning from incidents to staff. People told us they had found the service responded to concerns raised, but both staff and people using the service sometimes found the office difficult to contact.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 13 November 2020).
At our last inspection we found breaches of the regulations in relation to safe care and treatment and good governance. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was now meeting these regulations. We have made recommendations about how the provider audits risk management plans We will check whether the provider has acted on these at our next inspection.
Why we inspected
We carried out this inspection to follow up on action we told the provider to take at the last inspection. This inspection was prompted by a review of information we held about the service.
We carried out an announced focused inspection of this service on 8 September 2020 when 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 and Well-led which contain those requirements.
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 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 ‘Mihomecare Hammersmith and Fulham’ on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This service is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of the inspection there were 323 people using the service.
People’s experience of using this service
People told us they did not always receive a reliable service. Systems to monitor staff were not always used appropriately by care workers, who in some cases used the system to misrepresent their attendance at visits. Sometimes people living with diabetes received very late calls and therefore did not receive meals on time. People told us this caused problems for them.
The service assessed risks to people from moving and handling procedures and how many staff members were required to provide safe support. However, there were occasions when people did not receive care from two staff members when this was part of their care plan.
People told us they felt safe when care staff visited and were well treated by staff. There were robust plans in place to reduce the risk of COVID-19 transmission and ensue the appropriate use of personal protective equipment, which people told us was being used. The provider ensured that people’s medicines support was planned and monitored effectively. Staff were subject to appropriate pre-employment checks to ensure their suitability for their roles.
The provider had introduced a new electronic care management system. This allowed an effective way to plan people’s care and ensure that it was delivered and appropriately audited by managers. There were measures in place to allow staff to report concerns and staff told us these were addressed appropriately by managers. People had mixed feedback about receiving monitoring visits. We found that telephone monitoring was taking place, but did not always fully capture people’s experiences of care.
The provider worked with stakeholders to ensure continuity of the service during the pandemic period. Working practices were changed to minimise contact between staff and there were appropriate business continuity plans in place. People told us that they had had limited contact with the office about this subject and sometimes found it difficult to contact a manager when they needed to.
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 31 July 2019).
Why we inspected
We received concerns in relation to the management of call timings and monitoring. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this full report.
Enforcement
We have identified breaches in relation to safe care and good governance at this inspection.
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 work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Mihomecare Hammersmith and Fulham is a domiciliary care service which provides care at home services to people under contract to the London Borough of Hammersmith and Fulham. At the time of our inspection there were 383 people using the service.
The service was previously registered as part of Mihomecare Central London.
People’s experience of using this service:
People told us their care workers were sometimes late but mostly arrived on time. Punctuality and use of electronic monitoring systems had improved and people were protected from missed calls.
People received the right support to eat and drink when needed. The service assessed the risks to people from health conditions and worked well with health services to make sure people’s health needs were met. Concerns about people’s wellbeing were reported promptly to the local authority.
Care workers had a good understanding of how to recognise abuse and were confident managers would take their concerns seriously. Risks to people’s wellbeing were highlighted by established risk assessment procedures and there were plans in place to mitigate these. People received their medicines safely from care workers who had the right skills to do this.
Managers carried out regular checks on how care workers provided care and tested their skills and understanding. Care workers received the right training to carry out their roles.
People told us they were treated with dignity and respect by care workers and that their privacy was always respected. Managers carried out regular checks, phone calls and surveys to check people were happy with the service and made changes when people expressed concern or complained formally.
Managers had appropriate systems for monitoring and improving the service and communicating with care workers.
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 but were not always used effectively by staff.
We have made a recommendation about how the service checks that care is provided by two workers when required.
Rating at last inspection:
This was the first ratings inspection for this service. The service was previously part of Mihomecare Central London, which was rated ‘requires improvement’ in March 2018.
Why we inspected:
This was a routine first ratings inspection. We brought this forward at the request of the provider and the local authority. This was because both parties felt the service had improved since it was reorganised.
Follow up:
The service was rated 'good'. We will continue to monitor information and intelligence we receive about the
service until we return to visit as per our re-inspection guidelines. We may inspect sooner if any concerning
information is received.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk