About the service:

Care at Home Midlands Limited is a domiciliary care agency. It provides personal care to people living in their own homes. On the day of our inspection they were providing care for 178 people.

People’s experience of using this service:

¿ People were not consistently safe. The provider did not always ensure people received their care as planned or delivered by regular staff.

¿ The provider had not ensured all people’s experience of the service had been obtained.

¿ People knew how to make complaints but these were not always resolved satisfactorily. Where improvements were made these were not always sustained.

¿ Reviews of people’s care and support were not routinely carried out.

¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way and people were involved in decisions about their care.

¿ Risks to people were assessed and mitigated. Systems and processes safeguarded people from abuse. There were enough staff to keep people safe and meet their needs. People were protected by the prevention and control of infection and their medicines were managed safely. People were supported to eat and drink to support their well-being.

¿ People were treated with kindness and compassion. The culture of the service was positive and person centred. Staff communicated with people according to their individual needs and people’s independence was promoted and their dignity respected.

¿ Staff were supported with regular supervision, staff meetings and training. Staff told us they felt supported. New staff were recruited using safe procedures and were supported with an induction to the service.

¿ Staff worked well together and they shared information when necessary and people’s confidentiality was respected.

¿ The provider demonstrated working well with other agencies to improve care.

¿The service met the characteristics for a rating of “requires improvement” in three of the five key questions we inspected and a rating of “good” in two. Therefore, our overall rating for the service after this inspection was “requires improvement”.

Rating at last inspection: GOOD (Report published 01 August 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated requires improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out our inspection on 1 August 2016. The inspection was announced.

Care at Home Midlands is a domiciliary care service providing care and support to people living in their own homes. The office is based in Ratby in Leicestershire. The service provide support to people living in Leicestershire and surrounding towns and villages. They support people with a variety of care needs.

The service had 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 were safe when they used the services of Care at Home Midlands. Staff supported them to keep safe from abuse and avoidable harm. They reported any concerns they had about people’s welfare to the registered manager who dealt with their concerns appropriately.

People’s records included comprehensive risk assessment which guided staff to provide care in a safe manner whilst promoting people’s independence.

The provider had safe recruitment practices. They completed relevant pre-employment checks which assured them that staff were safe to work with people who used the service. There was sufficient numbers of staff to meet people’s needs safely. Staff were available for the full duration of their agreed support time.

Staff did not consistently complete people’s medication administration records (MAR) charts to show that they had supported them to take their medicines. However, we saw that the provider had identified this issue and had implemented new protocols to address this and support staff to fulfil this task.

Staff had the relevant skills and experience that they required to provide effective care to people. They had access to a comprehensive training which included training required to meet the specific needs of people that used the service.

People were supported in accordance to relevant legislation and guidance. Staff sought people’s consent before they provided their care and support and they applied the Mental Capacity Act 2005 in practice.

People who required support with their nutritional needs received it. Staff were supported to proactively support people with any changes in their health. They promptly referred people to health care professionals where required.

Staff were kind and compassionate to people who used the service. They demonstrated interest in the welfare of people that used the service and had knowledge of their needs and preferences. They provided care in a way that promoted people’s dignity and their right to privacy.

People had comprehensive care plans which reflected their current needs. The care that they received was centre on their individual needs.

Staff supported people to minimise the risk of social isolation. They supported people to access social activities and be part of their local community.

People had opportunities to provide feedback about the service they received. They provider acted on people’s feedback.

People felt included and satisfied in the development and quality of the service. They spoke highly of the management team. Staff felt supported in their role which enabled them to deliver a good standard of care. The provider had effective procedures for monitoring and assessing the quality of service that people received.