Archived: Help at Home (Melton Mowbray)

Help at Home (Melton Mowbray) is a domiciliary care service. Care and support is provided to people in their own homes. At the time of our inspection 106 people were using the service.

At the time of our inspection there was a manager in place. This person was in the process of registering to become the registered manager. It is a requirement that the service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People had mixed views about the running of the service and some people told us improvements could be made about the lateness of some calls they received. Staff did not always feel supported and felt pressurised to take on additional work. The area manager was taking action following this feedback to make improvements.

People and staff had opportunities to give feedback to the provider. For example, staff attended regular staff meetings where they could offer suggestions to improve the service. We saw that the provider took action where this was necessary following the feedback received.

Staff understood their responsibilities including reporting the poor practice of their colleagues should they have needed to. The provider’s whistleblowing procedures required improvement to include other organisations that staff could report poor practice to should they have needed to. The area manager took action following our feedback.

The provider was regularly checking the quality of the service. For example, checks of people’s care records were taking place as well as the health and safety practices of staff.

The provider had aims and objectives for the service that were known by staff. This included promoting people’s independence and dignity. We found that the aims and objectives were not always being met. For example, people were not always told when a staff member would be late for their personal care support.

The manager was aware of their responsibilities. This included them submitting statutory notifications of significant incidents to the Care Quality Commission where appropriate.

People felt safe with the support offered from staff. Staff understood their responsibilities to support people to protect them from abuse and avoidable harm. The provider dealt with accidents and incidents appropriately however, the recording of incidents was not always thorough. Risks to people’s well-being had been assessed and regularly reviewed. For example, where people were at risk of falling, there was guidance for staff to follow to support people to remain safe.

People’s homes and equipment were regularly checked and there were plans to keep people safe during significant incidents, such as a fire.

People were largely satisfied with the availability of staff and the time spent undertaking their care calls. We found calls were made to people in line with their care plans. People had mixed views on the regularity of the same staff providing their care. We saw that the area manager was trying to improve this. Staff were checked for their suitability before starting work for the provider so that people were protected from those who should not work in the caring profession.

Where people required support to take their prescribed medicines, this was undertaken in a safe way by staff who had received regular guidance and training. Staff knew what to do should a mistake occur when assisting people with their medicines.

People were largely receiving support from staff who had the appropriate skills and knowledge. Staff received regular guidance and training relevant to their role. For example, staff received training in Parkinson’s disease.

People were being supported in line with the Mental Capacity Act (MCA) 2005. People were asked for their consent before care was given and staff understood their responsibilities to regularly consider people’s capacity to make decisions for themselves.

People chose their own food and drink and were largely satisfied with the support they received from staff members. They had support to access healthcare services when required to promote their well-being.

People received support from staff who showed kindness. Their dignity and privacy was protected when receiving personal care support. Staff knew the people they offered care to and they were supported to be as independent as they wanted to be. For example, by choosing their own clothes.

Staff knew people’s preferences and had involved people in planning their own support where possible. Where people needed additional support to make decisions or to speak up, advocacy information was available to them.

People were not always satisfied with the punctuality of staff members providing their care. The area manager was monitoring this and taking action to make improvements.

People had contributed to the planning and review of their support where they could. People had care plans that were person-centred on them as individuals and had an assessment of their care requirements when they started to use the service. However, people were not always asked for their preference for a male or female staff member to provide their care. The provider was taking action to improve this.

People knew how to make a complaint. The provider had a complaints policy in place that had been made available to people. The provider took action when a complaint had been made.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Staff knew about risk management plans and told us about how they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The provider ensured that staff rotas where planned so that people's care needs were taken into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met. People had their needs assessed before they began using the service. People's needs were assessed by experienced staff.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. People were involved in developing their care and support plans.

People said that their care plans were up to date and reflected their current needs. A relative told us how vigilant the staff were. They told us that any changes were noticed quickly and reported to the appropriate person. They told us the support received had enabled their relative to remain in their own home.

Is the service caring?

We spoke with five people who used the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive. One person said about the staff 'They are part of the family'. Another person said 'Everything about the service is good, I have a really good carer'.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. People told us they could contact the agency at any time and had their care and support needs reviewed regularly. .

The service worked well with other agencies and services to make sure people received care in a coherent way.

Is the service well-led ?

The provider had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.