Background to this inspection
Updated
20 December 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 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care 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 it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 23 November 2023 and ended on 24 November 2023. We visited the location’s office/service on 23 November 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 5 people who used the service and 6 relatives about their experience of the care provided. We spoke with 10 members of staff including the director, nominated individual, registered manager, training and development officer, office staff, senior care staff and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 5 people's care records and numerous medication administration records. We inspected 3 staff files in relation to their recruitment. A variety of other records relating to the management of the service, including audits and policies and procedures, were also reviewed.
Updated
20 December 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
Emerald Care Services (North Lincs) is a domiciliary care agency providing personal care to people in their own homes. The agency provides support to older people, people who may be living with dementia, a learning disability or autistic spectrum disorder, a physical disability, sensory impairment or mental health needs.
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. At the time of the inspection 36 people were receiving personal care.
People’s experience of using this service and what we found
Right Support
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People had support from safely recruited staff. Staff received training in safeguarding and understood their role and responsibilities to protect people from abuse.
Systems were in place to record and respond to any accidents or incidents that occurred. People received their medicines when they needed them. Staff enabled people to access specialist health or social care support when needed.
Right Care
Care plans were not always fully complete or lacked relevant details about people's care needs. Care and support plans did not always provide sufficient guidance for staff on how to promote their wellbeing. However, people and relatives told us staff treated people with dignity, respect and in a person-centred way. Staff were kind and compassionate.
We received mixed feedback from people about call times, and duration of calls.
Right Culture
The culture of the service did not always enable staff to continuously learn and improve. For example, lessons learned from incidents were not always analysed and shared with staff.
The provider's quality monitoring processes were not always effective at highlighting issues found at this inspection. The provider offered assurances about actions they would take.
We received mixed feedback from staff about the support they received from management in order to fulfil their roles and responsibilities. Staff knew people well and were responsive to their needs. People and their relatives were involved in their care.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 November 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service and when the service was last inspected.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to consent and good governance at this inspection. We have also made a recommendation in relation to safe care and treatment.
Please see the action we have told the provider to take at the end of this 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.