MiHomecare - Ramsgate

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults, older adults, people living with dementia or mental health needs, physically disabled people and people with a learning disability or autistic spectrum disorder. There were 141 people receiving a service from MiHomecare Ramsgate at the time of our inspection. One person told us, "The job staff do, actually enables me to stay in my own home".

The registered manager had been working at the service since November 2016 and was registered with the Care Quality Commission CQC) shortly before our inspection. A registered manager is a person who has registered with the CQC 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.

At the last inspection on 25 November 2016, we asked the provider to take action to make improvements to the way they supported staff, assessed and mitigated risks, and ensured that information within care plans reflected people's assessed needs and preferences. At this inspection we found that all the shortfalls had been addressed and the service that people received had improved.

Everyone we spoke with told us the staff were kind, caring and friendly, and treated them with dignity and respect at all times. They told us staff knew them well and provided their care in the way they wanted. People were given privacy. Everyone was supported to be as independent as they wanted to be. People received care in the way they preferred at the end of their life from staff and health professionals.

People's medicines were well managed. Guidance was available to staff and people received their medicines as their healthcare professional had prescribed. Changes in people's health were identified quickly and staff supported people to contact their doctor. People were supported to eat and drink enough. Staff followed safe practices to prevent infections.

People received care tailored to them. Assessments of people's needs and any risks had improved since our last inspection. Guidance was now available to staff about how to keep people safe and provide each person's care in the way they preferred. Staff supported people to take part in leisure activities they liked.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Everyone was able to make decisions for themselves and staff supported them to do this. The registered manager understood their responsibilities under Deprivation of Liberty Safeguards (DoLS), and had checked to make

sure no one was deprived of their liberty.

Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager. People and their representatives told us they were confident to raise any concerns they had with staff and that these would be acted on. Complaints received were investigated and responded to. Action was taken to prevent them occurring again.

Staff arrived at the agreed time and stayed for the required length of time. People told us they knew if staff would be late and who would provide their care. Staff rotas were planned in advance and any gaps were covered. Staff were recruited safely and Disclosure and Barring Service (DBS) criminal records checks had been completed. Staff were supported to meet people's needs and had completed the training they needed to fulfil their role. Checks were completed to make sure training had been effective and staff were competent. Staff were clear about their roles and responsibilities and worked as a team to meet people's needs.

The provider and registered manager had oversight of the service and checked the service people received met the standards they required. People, their relatives and staff were asked for their feedback and any concerns were acted on and used to improve the service. Accidents and incidents had been analysed and action had been taken to stop them happening again.

Staff felt supported by the registered manager, they were motivated about their roles. They shared the provider's visions of a good quality service. An experienced member of staff was always available to provide the support and guidance staff needed, including outside of office hours. Records in respect of each person were accurate and complete and stored securely.

The registered manager had plans in place to contact other local providers and community organisations to share best practice and continually develop the service.

Services that provide health and social care to people are required to inform the CQC, of important events that happen in the service like a serious injury or deprivation of liberty safeguards authorisation. This is so we can check that appropriate action had been taken. We had been notified of all significant events at the service.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating in their public office and on their website.

The five questions we ask about services and what we found