Peace of Mind Home Care Solutions

Our previous inspection of the service on 5 January 2018 found two breaches of regulation in respect of staff support and quality assurance and we also made a recommendation in respect of medicines management. We previously rated the service as "requires improvement". Following the inspection, the service sent us an action plan detailing the action they would take to make improvements.

During this inspection 6 February 2019, we found the service had made improvements in respect of medicines management, supervision sessions and appraisals. The service had introduced quality checks and audits. However, we found that some of these did not always identify issues for example; Medication Administration Records (MARs).

People and relatives spoke positively about care workers and the service. They told us they were satisfied with the level of care provided and how the service operated. People told us they were treated with respect and dignity. Relatives told us they were confident that people were safe in the presence of care workers and were well looked after.

Our previous inspection found that MARs were not completed fully with details of medicines administered and we made a recommendation in respect of this. During this inspection on 6 February 2019, we found the service had introduced new format MARs which included details of the medicines included in the blister pack. These new format MARs clearly detailed the name of the person, their address, the name and dose of the medicines prescribed and allergies.

Care workers received medicines training and policies and procedures were in place. We looked at a sample of Medication Administration Records (MARs) and found that the majority of these were completed fully to indicate that medicines had been administered as prescribed.

Risk assessments were in place and were personalised and included information specific to each person and their needs.

People and relatives told us there were no issues with regards to care worker's punctuality and attendance. They told us care workers were mostly on time and if they were running late, the office contacted them to inform them of the delay. They also told us people experienced consistency in the level of care they received and received care from regular care workers. At the time of the previous inspection in January 2018, the service did not have an electronic system for monitoring care worker's timekeeping and duration of their visit. During this inspection in February 2019, the service had an electronic system in place which flagged up if a care worker had not logged a call to indicate they had arrived at the person's home or that they were running late.

Systems and processes were in place to help protect people from the risk of harm and care workers demonstrated that they were aware of these. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

We looked at the recruitment records and found background checks for safer recruitment had been carried out to ensure staff were suitable to care for people. Our previous inspection found staff were not consistently supported to fulfil their roles and responsibilities through supervisions and appraisals and we found a breach of regulation in respect of this. During this inspection in February 2019, we found the service had taken appropriate action to make improvements to address the breach of regulation. The service had implemented a system to ensure staff received supervisions, spot checks and appraisals and we saw that these were carried out regularly.

People and relatives told us they were confident that care workers had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working for the service. They told us that they received continuous support from management and morale amongst staff was good. Spot checks were in place to assess care worker's competency.

Care support plans were person centred and individualised. They addressed areas such as people's personal care, what tasks needed to be done each day, time of visits, people's needs and how these needs were to be met. They also included details of people's preferences and details of their history and interests.

Our previous inspection found the service did not have effective systems and processes in place to assess, monitor and improve the quality of the services provided. We previously found a breach of regulation in respect of this. During this inspection in February 2019, we found the service had taken action and made improvements. Following our previous inspection, the service had introduced systems to check and monitor various aspects of the service which included staff training, staff supervisions and spot checks. This enabled the service to continuously monitor this to ensure that these were carried out consistently. The service had also introduced a formal quality monitoring system which was carried out at various intervals over a year. This included two telephone calls and two visits annually and enabled the service to continuously obtain feedback from people and their relatives.

The service had also introduced a MAR audit which was carried out monthly. However, we found this audit was not sufficiently comprehensive. The service had also introduced an electronic system to monitor staff punctuality and attendance. This system enabled the service to print off data in order to monitor punctuality and attendance. However, we noted the service did not have a formulised system in place to review these on a regular basis. We discussed this with management who confirmed they would introduce these checks formally and revise the MARs audit.

The five questions we ask about services and what we found