About the service:

Cmichaels Healthcare is a small domiciliary care agency registered to provide personal care to people living in their own homes. The agency currently provides a service for people discharged from hospital and supported with end of life care. The service is also registered to provide a service for older people, people living with dementia, younger adults, children 13 to 18, learning disability and mental health. At the time of the inspection the service supported three people.

The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

People’s experience of using this service:

The provider’s governance systems to check the quality of the service provided for people were not consistently effective and required improvement. This meant the provider was not meeting the minimum standards required by law and you can see what action we have asked the provider to take at the end of this report.

People were protected from potential risk of harm but risk assessments were not always written to the person’s individual support needs to ensure staff provided a consistent level of care. People’s care and support needs were assessed although in parts, the assessments were generic and could be more personalised. Although the service appeared to specialise in the provision of care for people at their end of life, the provider could do more to ensure people’s end of life wishes were clearly explained within their care plans to ensure staff supported people consistently with their preferences for care at the end of their life.

Peoples’ relatives told us their family member was safe and there were sufficient numbers of staff that were safely recruited to support people. Staff had completed medication training but at the time of the inspection there was no support being given to people with their medicine requirements. Staff had access to equipment and clothing that protected people from cross infection.

Staff received the training they required to meet people’s needs. People accessed healthcare services to ensure they received ongoing healthcare support. People, as much as practicably possible, had choice and control of their lives and staff were aware of how to support them in the least restrictive way.

People were supported by kind and caring staff that knew them well. Staff encouraged people’s independence, protected their privacy and treated them with dignity.

People were supported by staff that knew their preferences. There were two complaints made since the service started that had been investigated and resolved. People and their families knew who to contact if they had any complaints.

People and their relatives’ views were sought about the quality of the care being provided. Staff felt supported by the management team.

People, their relatives and staff were happy with the way the service was managed and the provider worked well with partner organisations to ensure people’s needs were met.

The service did not meet some of the characteristics of Good in two areas and more information is in the detailed findings below.

Rating at last inspection:

This was the service’s first inspection since their registration in November 2017.

Why we inspected:

This was a planned inspection that took place on the 16 January 2019.

Enforcement:

Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up:

As we have rated the service as requires improvement, we will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.