Elmar Home Care

Updated 6 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector, an assistant inspector who made calls to staff and an Expert by Experience who made calls to people who used the service and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

Inspection activity started on 5 April 2023 and ended on 27 April 2023. We visited the location’s office on 12 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the date of registration. We sought feedback from the local authority and professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 5 people who used the service and 7 relatives about their experience of the care provided. We spoke with 8 members of staff including the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also received positive feedback about their role from a care-co-ordinator by email. We reviewed a range of records. This included 7 people’s care records and multiple medication records. We reviewed a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 6 June 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Elmar Homecare is a domiciliary care service providing personal care to people living in their own houses and flats. At the time of our inspection there were 67 people using the service some of whom had a learning disability.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Right Support:

Although the provider had systems in place in relation to call monitoring, people raised a number of issues with us about the timing of their care calls and the consistency of staff supporting them. People generally received support in line with their assessed needs. Assessments of people’s needs provided staff with guidance; however, some care plans would benefit from additional detail to improve the level of person-centred information for staff to follow. People's choices were generally promoted by staff who had a good understanding of how to promote people’s independence although one person told us a member of care staff had commented the person was “too independent.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

Staff knew what to do to promote people’s safety and protect them from avoidable harm. Medicines were managed safely although one person raised concerns with us about how issues with timing of their calls affected the administration of their time critical medicine. Care records needed some additional information to help staff get to know and understand the person they were supporting. People did not always feel as though they had been supported in making decisions about their care or being involved in the care planning process. Staff knew what to do to make sure people’s privacy and dignity needs were met.

We have made a recommendation in relation to managing consistency of staff and monitoring call times.

Right Culture:

The providers governance systems required further development; audits were regularly completed; however, some improvements were needed to the audit system to make sure issues with care documentation, call times and other issues described to us by people who used the service, were addressed. The management team were proactive in addressing our feedback in relation to concerns people had raised with us and we acknowledge the disparity of feedback we received with feedback received by the service when they conducted their own telephone survey with people following our feedback to them. Further work was needed to make sure people felt empowered to have full involvement in their care. Staff received training in key areas before commencing employment. The provider evidenced oversight of staff’s compliance with training. The providers recruitment systems were safe and the majority of staff felt well supported, valued and included in the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 22 September 2022 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this full report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.