Archived: Homebased Care (UK) Ltd

Homebased Care (UK) Ltd is registered to provide personal care services from the location of 34 Lichfield Street, Walsall, WS1 1TJ. The provider had moved from this location and had failed to amend this condition of their registration. The provider was now providing personal care from The Rock Church Centre, 27-31 Lichfield Street, Walsall, WS1 1TJ. This was the location from which we completed our inspection.

There had been no registered manager in post since February 2014. 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 not protected from the risk of abuse due to the provider’s failure to ensure safeguarding incidents were recognised, reported and investigated appropriately. People were protected by a staff team who did understand how to manage hazards in order to reduce the risk of harm such as injury. However, people were not sufficiently protected as accidents and incidents were not always recorded and monitored by the provider.

People were happy with the support they received with their medicines. However, records relating to the administration of medicines were not always completed clearly to demonstrate the support provided. People were supported by staff who had been recruited safely.

People felt most staff had the skills required to support them effectively. People were supported to provide consent on a day to day basis when they received care. However, where people lacked mental capacity, decisions were not always made on their behalf in their best interests in line with the Mental Capacity Act 2005.

People were given the support they needed to meet their needs around the food and drink they received. People were supported to access healthcare professionals and maintain their day to day health needs.

People were supported by a staff team who were kind and caring in their approach towards them. However, people did not feel the management team were caring in their approach. People were supported to make day to day choices about the care they received. People’s privacy, digity and independence were protected and promoted by care staff.

People were happy with the support care staff provided during their care visits. However, they said the time at which they received their care visits was a concern and did not always meet their needs. People were not always fully involved in the development of their care plan. People did not always feel their complaints were heard and responded to appropriately.

People did not know who the management of the service were and they did not always feel heard by the provider. Staff felt the provider and management team had been supportive. However, they felt the quality of the service and support they received was affected by the inconsistencies in the management of the service. The provider had developed quality assurance systems, however, they were not sufficient in identifying the concerns we found during our inspection. Quality assurance systems were inadequate and were not effective in identifying areas of risk and improvements needed.

We found the provider was not meeting the regulations around safeguarding people, the need for consent, the management of the service and their registration with CQC. You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We found that the service had made improvements to their quality monitoring systems which had improved the quality of care being delivered to people who used the service. People who used the service told us they were happy with the care they received from West Midlands Homebased Care.

We looked to see if people who used the service consented to their care, treatment and support. We found that the service had systems in place to record that people had consented to their care.

At our previous inspection in November 2012 we had concerns that the care and welfare needs of people who used the service were not being met. Following this inspection we still had concerns that the care and welfare needs of people are not always met.

We looked to see if the service was meeting the requirements in the recruitment of new staff. We found that the service did follow the correct recruitment procedure.

At our previous inspection we had concerns that the service's quality monitoring systems were not effective, at this inspection we continued to have concerns that the systems do not ensure appropriate care delivery.

We looked to see if the service had a complaints procedure. We found that there was a procedure but not everyone who had a concern chose to use it. Most complaints had been received through the local authority and acted on appropriately.

West Midlands Homebased Care ltd were non-compliant in two of the five outcome areas we looked at.

We found an interim manager was in place as the registered manager had left several months ago. We had not been informed about this. The interim manager told us that they had been employed to improve the quality of the service being delivered.

Staff told us they enjoyed working for the service and felt supported in their role.

We found safeguarding procedures were in place and staff were knowledgeable in the use of them.

People who used the service told us they were generally happy with the service but had concerns about poor care they had received which was now being addressed. We had concerns over the care and welfare of people who used the service and the quality monitoring of the service provision.