Responsive Care

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Mi Casa Care Ltd is a domiciliary care agency providing personal care to people in their own homes. At the time of the inspection, the agency was supporting 32 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported to achieve goals and wishes by staff that were knowledgeable and whom had built relationships with them. This ensured staff could focused on people’s strengths and encouraged them to remain as independent as possible.

Right Care:

Risk assessments and care plans were person centred and provided staff with clear guidance on how people wished to be supported. Care plans contained processes with clear instruction for staff to know when and how to seek additional medical help.

Staff had training on how to recognise and report abuse and they knew how to apply it, this ensured people were protected from harm and abuse. Staff understood people's cultural needs and provided culturally appropriate care. People we spoke with told us they felt safe and respected by the staff who cared for them.

Right Culture:

The registered manager had a clear vision for the service and was open and transparent. Staff told us they were supported and able to raise concerns freely to management team. There were effective systems and processes in place which ensured the care delivered was monitored, assessed and improved upon.

The provider worked in partnership with other professionals and had been successful in reducing hospital admissions by upskilling and sharing best practices with other organisations.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 February 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 31 December 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the regulations; safe care and treatment, fit and proper persons employed and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions; Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mi Casa Care Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Mi Casa Care Ltd Nottingham is a domiciliary care agency providing personal care to people in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. There were 33 people receiving regulated activity at the time of the inspection including, two who received live in care (This means care staff lived at the person’s home).

People’s experience of using this service and what we found

The provider was not following safe recruitment policies and procedures. Risks to people's health, safety and welfare had not always been appropriately assessed or reviewed. People received their medicines as prescribed, but not always at the same time each day.

People’s needs were assessed, but care plans were not always updated immediately. More detail was required to make it clear what support people needed and that their choices and preferences would be adhered to. There had been disruptions to the call rotas this made call times unpredictable.

The provider failed to provide good governance and effective communication systems to promote the service. The provider understood and acted on the duty of candour. They acknowledged shortfalls found at the inspection.

People were supported by kind and caring staff. People were encouraged to express and share their views about the service. People’s choices and independence was promoted, and their privacy and dignity were upheld.

The provider promoted a positive culture that was open, inclusive and engaged people using the service. The provider was keen to learn and improve the service. They worked well with relevant professionals.

The provider followed protocols for infection control to protect people from the risk of infections. There were systems and processes in place to make sure people were kept safe from avoidable harm. Lessons were learnt following incidents and concerns as analysis and robust investigations had taken place.

People received sufficient amounts to eat and drink. People were supported to live healthier lives with referrals being made in a timely manner. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Care was planned and personalised to ensure people had choice and control to meet their needs and preferences. People were assessed to ensure their communication needs were met. Relationships with family and friends were maintained, which helped people to avoid isolation. Complaints that had been received had been appropriately investigated and responded to. Lessons had been learned and changes made to staff practice when required. Processes were in place to support people with end of life care and training was provided when required.

We have made recommendations about promotional material and end of life care processes.

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

This service was registered with us on 27/11/2018 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the provider’s recruitment and training process. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

We have identified breaches in relation to assessments of risk for people’s needs, safe recruitment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.