15 March 2021
During a routine inspection
Careinmyhome is a service providing personal care to approximately 26 people with a range of health and support needs at the time of the inspection. 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 were not always protected from harm. Risks to people had not been adequately assessed to ensure people received safe care and treatment. The provider had not ensured all staff had the skills and knowledge to provide care safely. Infection prevention and control systems were sufficient to protect people, although one of the provider’s policies relating to Covid-19 contained information that was not in line with current government guidance. New staff were recruited safely.
Care records were held electronically. When people started to use the service, some staff needed to call the office to obtain more information about people’s care and support needs. Some staff had not completed all the necessary training. For example, no staff had undertaken training on catheter care, and some people used catheters. After the inspection, the provider arranged for staff to receive this training. There were gaps in some care plans which provided inconsistent information about people's care and support to enable staff to be aware of and fully meet their needs.
People were aware that there had been recent changes in the management team. At the time of the inspection, the Worthing office was closed due to staff having to self-isolate, so calls were put through to one of the provider’s other offices. Systems to monitor and measure the service were not effective, nor sufficiently robust to drive improvement.
People felt involved in decisions about their care and that staff would always check with them before undertaking any personal care. People confirmed that staff assisted them to maintain a healthy diet, and that if they needed any healthcare support, staff would ring the relevant healthcare professional.
People said that staff were kind and caring and that relationships with carers were good. People were treated with dignity and respect and their independence was encouraged. 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.
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 4 April 2019 and this is the first inspection.
Why we inspected
This inspection took place because of concerns we received. These concerns related to care plans, risk assessments, and the management of staff. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see all key questions 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 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to providing safe care and treatment, and the overall governance and management of the service.
Follow up
We will request an action plan for 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.