Archived: Homebased Care (UK) Ltd- Erdington

After the inspection we received concerns in relation to the financial viability of the service. As a result we undertook a comprehensive inspection. This inspection was announced and took place on 24 and 29 January 2018. We gave the provider 48 hours’ of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office.

Homebased Care (UK) Ltd - Erdington is registered to provide personal care to people living in their own homes. On the day of our inspection the service was providing personal care to 77 people.

At the time of our inspection a registered manager was showing on our records. However, during the inspection we found they had been left for over six months; therefore a registered manager was not in place and had not been notified to us as legally required. 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 being managed by the care manager until another branch manager moved across to the Erdington branch and registered with CQC.

People told us that staff frequently arrived late for calls and on occasions calls were missed. People told us they were reliant on staff and late and missed calls left them waiting for support; personal care and meals.

Staff were clear about their roles and responsibilities in keeping people safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe.

People told us they received their medicines as required and staff said they had received medication training to support people appropriately.

People told us regular staff knew them well and had the skills and knowledge to meet their needs. Staff told us they received the right training for the people they supported.

People said staff supported them by preparing a choice of meals and drinks to support their wellbeing. Staff understood they could only care for and support people who consented to being cared for.

People told us that although individual staff were caring they felt the service was not caring because they felt anxious and upset that staff were not being managed well and they were worried they would lose their support. Where people had regular members of staff they praised them and they had developed good relationships with staff who they said were caring. Staff treated people with privacy and dignity and respected people’s homes and belongings.

People told us they knew how to raise concerns but they felt these were not always listened to or action taken to resolve them. The provider had a system in place to deal with any written complaints. Written complaints received were logged and investigated.

People said the management of the service needed improving to ensure the correct management of staff and to ensure calls were made on time to meet their needs and by regular staff.

Relevant notifications had not been submitted to CQC where safeguarding reports had been referred to the local authority. CQC requires this information to look at the risks to people who use care services.

Governance systems were not effectual in ensuring that calls were made on time to meet people’s needs. There had been a period of change within the service that had impacted on the care provided. This was acknowledged by the provider who was looking at ways to take action going forward.

You can see what action we told the provider to take at the back of the full version of the report.

Homebased Care (UK) Limited is registered to provide personal care services to people in their own home. At the time of our inspection 139 people were receiving a service.

There was a registered manager in post at the time of our inspection but they were not available to assist during the inspection and people were not aware of who the registered manager was. 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 registered manager was not fulfilling the requirements of their registration to ensure all the required notifications were sent to CQC (Care Quality Commission) to enable them to monitor that people were protected. You can see what action we told the provider to take at the back of the full version of the report.

The quality assurance systems were not sufficient to monitor, identify shortfalls and make the necessary improvements to the service to ensure people were receiving the service as required.

People knew how to raise concerns they had but not everyone felt they were listened to, their concerns taken seriously and that the response from the provider was not always timely. People felt that communication with them could be improved regarding calls, carers who were supporting them and the managers responsible for the service.

People were mostly happy with their regular carers but some people had concerns about the service provided at weekends and periods of staff sickness and holidays. Some people were unhappy that they had not always received a service at the time they had requested or for the length of time they had requested.

People were supported by staff that had the skills and knowledge to identify the risk of abuse and to raise concerns if needed. Safeguarding concerns were raised with the local authority but notifications were not always sent to CQC (Care Quality Commission) so that we could monitor the service and ensure people were protected.

People were protected by a staff team who understood how to manage hazards in order to reduce the risk of harm and had access to care plans and risk assessments to support them. People were supported to take their medicines, receive support with personal care and felt involved in their care. People felt generally staff had the skills to support them appropriately.

People were supported by staff that were kind and caring towards them and with whom they had built good relationships and who respected people’s privacy and dignity. Staff supported people to make choices and give consent to care.