Archived: MiHomecare - Reading

The inspector gathered evidence against the outcomes we reviewed to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what was found. The summary describes what people who use the service, relatives and staff told us, what we observed and the records we looked at.

Is the service safe?

Care and treatment was planned and delivered, however some care plans lacked information to ensure that people's safety and welfare was being managed effectively. Not all care plans were centred on the person's preferred individual routine. They did not include people's choices and preferences or provide adequate guidance for staff. This meant that people were not protected against the risk of unsafe and inconsistent care. A compliance action was issued for this and the provider must tell us how they plan to improve.

The provider had a robust recruitment procedure and appropriate checks were undertaken before staff began work.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). We found that the manager was aware of a recent Supreme Court judgement relating to 'deprivation of liberty' and had liaised effectively with the local authority DoLS team.

We found that staff records were accurate and the files were maintained to a good standard. However some of the personal records for people who used the service were not fit for purpose and we found that records were not always held securely. A compliance action was issued for this and the provider must tell us how they plan to improve.

Is the service effective?

Most people we spoke with told us they were satisfied with the care being provided. One person said staff were: 'kind' and another told us they were like friends and looked forward to them visiting. A relative told us: 'they are always polite and cheerful.'

There were mixed views with regard to the continuity of staff. One relative told us: 'the team is too large, they do not get to know people so they don't understand their needs.' They told us they felt the care their relative received was not personalised because they did not have regular care workers. However, another person told us they have the same care worker each day and they were: 'very happy.' Whilst another said they have regular care workers and they: 'wouldn't have a word said against them.'

Is the service caring?

People we spoke with told us that when they had started receiving services they had been able to discuss their requirements with a senior staff member. They told us they were able to express their views about care and support and how they wished to receive it.

People we spoke with and their relatives told us staff were respectful. They said staff addressed them by their preferred name and always explained what they were doing. One person told us 'the regular carers are very good, they look after people well and are very caring.'

Is the service responsive?

The staff we spoke with said they were informed when changes had been made and new care plans were put in place to make sure they had current guidance. One care worker said: 'I always make sure I know about changes, it's important.'

We saw some care records and risk assessments had been recently reviewed and updated. However not all care plans we looked at had been reviewed in a timely fashion. The manager was aware of this and had produced a spreadsheet to identify those care plans in need of review. A compliance action was issued for this and the provider must tell us how they plan to improve.

Is the service well led?

Most people and relatives we spoke with confirmed they were asked for their feedback about the service and it was acted on. We saw that incidents and accident reports were completed and investigated appropriately and that learning had taken place. We reviewed the complaints log and saw that complaints were recorded, investigated, responded to and followed up to ensure the complainant was satisfied with the outcome.

We spoke with a Quality and Performance Monitoring Officer from the local authority. They described the service as reasonably responsive to concerns. Call timings were not always adhered to but there were few complaints from service users.

The people we spoke with told us that care staff were mostly on time and always stayed for the right amount of time. One person told us that if staff were going to be late they were not always informed. Another person said that if they cancelled the calls care staff were not always informed and care staff would often still turn up. The provider had recently reorganised and recruited additional staff for the office which should improve communication with people. Staff told us that they always followed care plans which they felt contained adequate information.