Eniola Care Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At the last inspection the provider had not put in place effective auditing processes. There was no analysis of patterns or trends or details of actions taken when things were missed. Some accidents and incidents had not been recorded. A phone application with no password protection was used by staff to share sensitive information. There was no effective way of capturing feedback from people, relatives or staff. These failings were a breach of regulation. Although some improvements had been made for example, the phone application was now password protected, not all systems and processes were in place to enable effective auditing and the service remained in breach of regulation. There were ongoing issues relating to auditing processes. Some processes had been put in place but there were more that needed to be captured by managers. For example, analysis of accidents and incidents. Training records had not been kept up to date and records of staff feedback were inconsistent. The provider was aware of their responsibilities to report certain events to the local authority and CQC. The provider had met with staff and provided some reassurances about the future of the service. Positive working relationships had been established with statutory partners and professionals. People’s equality characteristics were respected but the provider was aware that more needed to be done to support staff needs.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The recent changes in manger at the service and the current absence of a registered manager had had an impact on systems, processes and staff. The provider had employed a consultant to assist them in putting new systems and processes in place to ensure the safety of people and support ongoing continuity of care. It has been identified elsewhere in this assessment the need for improvement to learning lessons when things go wrong, improvement to care plans, auditing, PRN protocols and support for staff. The provider acknowledged that these improvements were needed and systems were being put in place but needed time to develop and embed into day to day practice.

The provider had an understanding of where the service needed to improve. They had already undertaken staff meetings and meetings with all people and their families to offer reassurance during the current changes to management. The provider had drawn up an action plan and was working closely with the local authority to implement change and improvements.

Staff told us that in the absence of a manager they were able to contact the provider for support and advice. They told us that they had received supervision meetings but these were not regular. Staff had access to an ‘on-call’ process where advice could be sought from the provider if needed. The previous on call rota had included 3 people from the management team but this has temporarily been reduced to one point of contact.

The provider told us that systems were in place for additional recruitment of staff if the service increased its number of clients in the future. The provider was aware of previous issues that affected staff for example, lack of pay slips, few development opportunities and delayed holiday pay and had recruited a consultant to support them in addressing these concerns. The resolution of these issues again needed time to embed. We were told that a new manager had been selected but had not yet registered with CQC.

There had been a turnover in staff and since March 2024 half of the staff were new. Staff told us they found the provider approachable and supportive but there were not regular opportunities to provide feedback.

The provider acknowledged the need to improve regular, formal communication with staff. A new process of supervision meetings had been set up but had not yet had a chance to develop. The service improvement plan and local action plan drawn up with the support of the local authority contained details of how staff voice could be better heard.

Despite concerns being raised by staff about working conditions, although these were improving, there were few issues raised relating to equality. Staff said, “No discrimination, not at all” and “Not discriminate against.” The provider was exploring new ways of supporting people and staff from different cultural backgrounds.

The provider was aware of the issues previously affecting staff and was being supported to put processes in place to support staff and their different needs. Some staff members told us previously they did not think the area they worked was very multi-cultural and that they may move to an area with greater diversity. The provider was considering ways to reflect staff needs and different cultures. People’s equality characteristics were highlighted at the pre-assessment stage with any specific care and support needs being recorded and staff being made aware.

The provider acknowledged the shortfalls in the current auditing processes. At our assessment visit in March 2024 we were shown a list of all areas of the service that required auditing and it was explained that, although some historic paper copies existed, very few had been inputted onto the computer system that the service had been using for the past 12 months. The situation at this assessment had not moved on from this and auditing processes remained incomplete. There were plans for improving this system and establishing full and regular oversight of all risk areas of the service. All areas of the service required auditing, examples included accidents and incidents, timings and attendance at care calls, staff supervisions, training and medicines. In March 2024 we were told that ‘spot checks’, unannounced visits from supervisors to staff to check on their work, took place. These too had now been completed in the past 4 months.

There was missing documentation across a range of processes and procedures. This resulted in several areas not being able to be effectively monitored or audited. For example, the training matrix had not been updated and no refresher training dates had been recorded. The auditing work that had begun at our assessment visit in March 2024 relating to care call times and accidents and incidents had not progressed. The provider had employed an independent consultant and plans had been drawn up to address these shortfalls. However it would take some time to fully implement and embed into practice. Similarly, processes for getting feedback from people and relatives had been inconsistent over the past 6 to 9 months and there was no analysis seen on the historic feedback that had been received. This again was an area that was being addressed but also needed time to embed.

Most people either made their own appointments with other health and social care professionals or had relatives that could do this for them. People and their relatives told us that the service worked well with other partners. If support were needed for people to see a community nurse then arrangements would be made by the staff. Similarly, rehabilitation services, GP’s and Occupational Health were contacted if needed.

Staff also told us that they knew who to contact if people needed more support than the service could provide or if there were a specific need due to a person being unwell or having had an accident. Staff added that internal relationships with other carers and managers had improved recently.

Professional statutory partners told us that they worked well with the managers and staff from the service who they found responsive and willing to work together to improve outcomes for people. The local authority told us that since the last inspection they had been supporting the service to make improvements in several areas. They told us that the provider was willing to engage and was beginning to work well together to establish better working practices. Occupational Health and community nurse further reported positive working relationships with the service.

The managers had developed a positive working relationship with the local authority and after the last inspection were also in regular contact with the CQC. There was evidence from staff of regular meetings and involvement with district nurses. We signposted the new manager to managers forums and newsletters.

The provider had a clear view about the current shortfalls of the service and shared with us plans for improvements moving forward. It was acknowledged that the absence of analysis of feedback from people, relatives and staff had resulted in no improvements or suggestions being recorded or acted on.

The provider had initiated an overview of all systems and processes to ensure full oversight moving forward. The previous manager had made improvements following the last inspection however there was more to be done to improve record keeping. One tangible improvement was the use of the alert system on staff mobile phones which were linked to the computer program for all records. Managers were notified immediately when care calls and details of medicines given, had been done. Although it was unclear who was monitoring this at the time of this assessment.