We undertook an announced inspection of MiHomecare-Brent on 27 March 2018.

MiHomecare-Brent is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides a range of domiciliary care services which include domestic support, administration of medicines and food preparation. At the time of inspection the service provided care to approximately 51 people.

There was a registered manager in post. 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.

The previous comprehensive inspection took place on 29 February 2016 and we rated the overall service as Good. We found a breach of regulation in respect of risk assessments and found that under “safe” the service required improvement. Following this, we carried out a focused inspection on 24 March 2017 and found that the service had made necessary improvements in respect of risk assessments and we therefore rated the service as Good under “safe”.

People who used the service spoke positively about the care they received. They told us they felt safe around care workers and were happy with the care provided by care workers and management at the service. Relatives we spoke with confirmed this and said that they were confident that people were well looked after.

Risk assessments were in place which detailed potential risks to people and how to protect people from harm. Risk assessments included detailed information about preventative actions that needed to be taken to minimise risks as well as clear and detailed measures for care workers on how to support people safely. At the end of each person’s risk assessment, there was a “high risk” summary. This provided a quick reference summary of those areas identified as high risk. Care support plans included a contingency plan and this helped establish which people were high risk and detailed what action to take in the event of an emergency.

Systems and processes were in place to help protect people from the risk of harm. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

We spoke with people and their relatives and asked whether care workers turned up on time and if there were any missed calls. All people told us they had not experienced a care worker not turning up and care workers were usually on time.

There were comprehensive and effective recruitment and selection procedures in place to ensure people were safe and not at risk of being supported by staff who were unsuitable.

Appropriate arrangements were in place in respect of medicines management. Records indicated that staff had received training on the administration of medicines and their competency was assessed. We noted that there were some gaps in medicine administration records (MARs) and raised this with management. They confirmed that the medicines had been administered but that MAR had not been completed. We noted that the gaps we found in the MARs had been identified by audits carried out.

Care workers had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers were provided with an induction which provided practical training and shadowing. Care workers also received on-going training. Care workers spoke positively about their experiences working for the service. They told us that they received continuous support from management and morale amongst staff was positive.

Care workers were aware of the importance of treating people with respect and dignity. Feedback from people indicated that positive and close relationships had developed between people using the service and their care worker.

Care pla

At our last inspection of MiHomecare-Brent on 29 February 2016 we found that there was a breach of legal regulation. This was because the provider did not always ensure risks to people were identified and appropriately managed.

We undertook this announced focused inspection on the 24 February 2017 to check the provider had taken action and were now meeting legal requirements.

This report only covers our findings in relation to the safety topic area. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for MiHomecare-Brent on our website at www.cqc.org.uk.

At our last inspection in February 2016 we rated the service good and in the four topic areas; effective, caring, responsive and well-led. The service was rated requires improvement in the topic area safe. The overall rating was good and the overall rating continues to be good after this inspection.

MiHomecare-Brent is registered to provide the regulated activity personal care to people in their own homes. At the time of the inspection, the service was providing care and supporting 45 people.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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.

At this focused inspection on the 24 February 2017, we found the legal requirements had been met. The provider had taken action to address our concerns about the way risks to people were managed.

We found risk assessments had been updated and risks were identified according to people’s specific care needs. There were risk management plans in place and risks were managed so that people were safe and their freedom supported and protected.

We undertook an announced inspection of MiHomecare-Brent on 29 February 2016. MiHomecare - Brent is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. The service provides a range of domiciliary care services which include domestic support, administration of medicines, food preparation and live in care. At the time of inspection the service provided care to approximately 60 people.

There was a registered manager in post. 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.

The service was registered by the Care Quality Commission on 19 May 2014 and the inspection carried out on 29 February 2016 was the first inspection for the service since its registration.

People who used the service and relatives informed us that they were satisfied with the care and services provided. People told us they were treated with respect and felt safe when cared for by the service. They spoke positively about care workers and management at the service.

Individual risk assessments were completed for each person. However, the assessments contained limited information and some areas of potential risks to people had not been identified and included in the risk assessments. This could result in people receiving unsafe care and we found a breach of regulations in respect of this.

There were safeguarding and whistleblowing policies in place and records showed staff had received training in how to safeguard adults. Care workers demonstrated an awareness of the different types of abuse and actions to take in response to a suspected abuse.

People told us their care workers turned up on time and they received the same care worker on a regular basis and had consistency in the level of care they received.

People were cared for by staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff spoke positively about their experiences working for the service and said that they received support from the registered manager.

Staff had a good understanding and were aware of the importance of treating people with respect and dignity. They also understood what privacy and dignity meant in relation to supporting people with personal care. Feedback from people indicated that positive relationships had developed between people using the service and their care worker and people were treated with dignity and respect.

People received care that was responsive to their needs. People’s daily routines were reflected in their care plans and the service encouraged and prompted people’s independence. However we found that there was limited information about people’s preferences in care plans and raised this with the registered manager. She confirmed that they would update care plans so that they included more detail about people’s likes and dislikes and life history.

The service had a complaints procedure and there was a record of complaints received. Complaints we examined had all been responded to and staff knew what action to take if they received a complaint.

People using the service spoke positively about the service and told us they thought it was well managed. There was a clear management structure in place with a team of care workers, office staff, field supervisors, quality and performance manager and registered manager.

Systems were in place to monitor and improve the quality of the service. We found the service had obtained feedback about the quality of the service people received through review meetings and telephone monitoring. Records showed positive feedback had been provided abou