About the service:

Umbrella Care (Midlands) Ltd is a domiciliary care agency that was providing personal care to 12 people at the time of the inspection. People that were being supported at the time of inspection had a range of support needs, such as people living with dementia and people with physical disabilities.

People’s experience of using this service:

At the last inspection in February 2018, the service was rated as Requires Improvement overall, with breaches of the regulations in relation to consent, staff training, registration requirements and governance. At this inspection, we found that the provider had made considerable improvements and there were no longer breaches of the regulations. The home had improved and is now rated as Good.

People felt safe and risks were planned for. People had their needs assessed and had access to health care professionals when needed. People were supported when nearing end of life, although people were not routinely supported with end of life wishes, meaning that future plans had not been discussed with people. Following our feedback, the provider had plans to ensure this was put into place and recorded in care plans.

There were enough staff to ensure people received timely support and staff were recruited safely. People were supported safely with their personal care by staff that knew them well. People had their preferences taken into consideration although people were not asked about their sexuality, following our feedback, the provider had plans to ensure this would be implemented and recorded during people’s admission stage.

People received support that met their needs. People could complain when they needed to and complaints were investigated and dealt with. People and relatives were asked about their views and had opportunities to complete surveys.

Lesson were learnt when things went wrong and systems improved if needed. The managers were responsive and approachable to people that used the service and to the staff. The managers had a clear understanding of their responsibilities of their registration with us.

Rating at last inspection:

At the last inspection the service was rated as; Requires Improvement (report published 27 February 2018) and was in breach of regulations. At this inspection we found the service was no longer in breach and the overall rating had improved.

Why we inspected:

This was a scheduled inspection based on the previous rating, to which the provider submitted an improvement plan at the last inspection.

Follow up:

We will continue to monitor the service through the information we receive.

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

We carried out an announced inspection at The Office at Hollin House on the 11 and 12 January 2018. This was the first ratings inspection since the provider had registered with us in May 2017. We found there were breaches in Regulations of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults and younger adults who have a physical or learning disability. Not everyone using The Office at Hollin House receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.

We found that the systems in place to monitor and manage the service were not effective. This meant there was a risk that unsafe and ineffective care was not identified.

The provider had not notified the commission of a change to their registration as required.

Improvements were needed to ensure that records contained accurate and up to date information.

The provider was not always following the principles of the Mental Capacity Act 2005. This meant that people were at risk of receiving care that was not in their best interests.

Improvements were needed to ensure people’s cultural and diverse needs were assessed and recorded to enable a fully individualised care provision that met people’s preferences.

Improvements were needed to ensure staff had guidance to administer and prompt people to take their medicines safely. Improvements were needed to ensure that the provider had safe recruitment procedures in place.

People were supported to eat and drink sufficient amounts and nutritional risks were assessed and monitored.

People’s health was monitored and health professionals input was sought where needed.

Staff were aware of their responsibilities to protect people from the risk of harm. Staff knew people’s risks and supported them to remain as independent as possible whilst protecting their safety.

There were enough staff available to meet people’s needs in a timely way. Infection control measures were in place to protect people from the potential risk of cross infection.

People were supported by caring and compassionate staff.

People’s choices were promoted and respected by staff and staff understood people’s individual communication needs. People’s dignity was maintained and their right to privacy was upheld.

People’s care was reviewed to ensure they received support that met their changing needs. People received care from a consistent staff group which met their individual needs and preferences.

People and relatives knew how to complain and the provider had a complaints procedure in place.

People, relatives and staff felt able to approach the registered manager and provider.

Feedback had been gained from people and relatives which had been acted on to improve the service.