Date of assessment 13 August to 25 October 2024. Ohio Home Care Ltd provides personal care to people in their own homes. There were 20 people using the service when we carried out the assessment. The assessment was carried out by 1 assessor. During the assessment we contacted 5 people or their relatives, and 8 care staff for their feedback about the service. We looked at 23 quality statements and found people received a service that was safe, and provided by competent, professional, trained staff. Staff were appropriately recruited, and they enabled people to take acceptable risks. People were supported to maintain their independence, had choices regarding the service they received, and control over when they received it. People received equitable experiences of the service provided, and outcomes. The service was well led, there was good governance, and effective monitoring systems. The rating has changed from requires improvement to good. For those areas and quality statements we did not assess, we used the ratings awarded at the last inspection to calculate the overall rating. We did not identify breaches of any Regulations during this assessment. We will continue to monitor information we receive about the service, which will help inform when we next assess them.
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Ohio Home Care Limited was rated Requires Improvement overall following inspections in October and November 2022, down from Good in 2019, due to significant governance failures including failure to notify CQC of safeguarding incidents, an incomplete safeguarding log, unresolved complaints, and timekeeping inconsistencies. While staff were praised for their caring attitudes and the service was effective in training, consent and infection control, leadership and oversight were insufficiently robust to ensure consistent, safe and responsive care.
Concerns (8)
criticalSafeguarding: “Although there was a central safeguarding log in place, it was not being updated and did not include all the safeguarding investigations that had taken place.”
criticalGovernance: “The provider had failed to notify CQC of safeguarding incidents and other notifiable incidents since the last inspection, of which they have a legal requirement to do so.”
moderateRecord keeping: “There were some inconsistencies with the information recorded in people's daily logs which meant important details and information related to care and support had not always been recorded.”
moderateCare planning: “For 3 people who were unable to mobilise independently, there was limited information about how staff supported them safely and it was unclear how moving and handling tasks were carried out.”
moderateMissed or late visits: “There are times where they turn up late or only one of them turns up. Two relatives also told us there are times when care staff do not always stay for the full visit.”
moderateComplaints handling: “The provider was not always keeping a record of all the complaints they had received...we could not be assured the provider was following their complaints procedure.”
moderateCommunication with families: “When I phone, they promise to ring back but they don't. One relative told us their care worker had challenged them directly when they were in their home and told them to stop calling.”
moderateIncident learning: “Items that had been identified as areas of improvement had not been fully implemented. Issues had been identified with the safeguarding log in May/June 2022 but our findings showed this had not been rectified.”
Strengths
· Staff were kind, caring and had developed positive relationships with people; the majority of feedback about staff attitudes was positive.
· Safer recruitment procedures were followed including DBS checks, references and employment history reviews.
· Staff completed induction, Care Certificate training, safeguarding training, MCA training and regular supervision.
· Medicines safety procedures were in place with competency assessments before staff supported people with medicines.
· Infection prevention and control procedures were followed; staff had adequate PPE and were regularly updated on COVID-19 guidance.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff working with other agencies; supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Planning personalised care to ensure people have choice and controlRequires improvement
responsive: Meeting people's communication needsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: Continuous learning and improving careRequires improvement
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Working in partnership with othersGood
well-led: How the provider understands and acts on the duty of candourRequires improvement