Archived: Emerald Care Services (North Lincs) Ltd Also known as Emerald Care Services

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.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults, people with a learning disability and people with mental health needs.

Not everyone using Emerald Care Services receives a regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 30 people were receiving a regulated activity.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. The caring domain has improved to outstanding.

Staff were passionate about providing person-centred care to people. They promoted their independence, dignity and privacy, rights, choices, aspirations and wellbeing. People were supported by staff with whom they had developed meaningful relationships and knew them well. Staff put in extra time and effort to ensure people continued to receive high quality consistent care. Staff were compassionate and ensured people felt valued. Staff communicated with people effectively dependent on their individual needs.

Staff continued to protect people from avoidable harm, were knowledgeable about safeguarding and able to raise concerns. Staff supported people to manage their medicines safely, where needed.

Steps had been taken to ensure suitable staff were employed, who were supported in their role and were skilled in providing effective care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care plans were kept up to date and reflected their individual needs and circumstances which enabled staff to provide person-centred care. People were supported to follow their interests and live their lives as they chose to. Staff used imaginative ideas to enable people to follow their interests and access and engage in hobbies and activities which were meaningful to them.

People were able to make a complaint if needed and their feedback was gathered to help drive improvement. Systems were in place to identify shortfalls and ensure quality care was provided, although there were some minor areas for development. There was a positive culture within the service, good team work and good staff morale was evident. Staff felt valued and supported. The registered manager was approachable and driven to consistently improve the service so that people received compassionate high-quality care.

Further information is in the detailed findings below.

The last inspection was completed on 15 and 23 January 2015 and was found to be compliant with the regulations inspected at that time. This inspection took place on 23 February 2016.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service were protected from abuse and avoidable harm by trained staff who could recognise the signs of potential abuse and knew how to keep people safe. Staff had been recruited safely and were employed in sufficient numbers to ensure the people’s needs were consistently met. Staff supported people take their medicines as prescribed.

Staff received a range of training to ensure they had the skills and abilities to meet people’s assessed needs. Appropriate levels of support and mentorship were provided to enable them to carry out their roles effectively. Staff understood the need to gain consent before care and treatment was provided. People were supported to attend healthcare appointments and staff contacted relevant professionals in a timely way when people’s needs changed. Staff prepared meals for people as required and encouraged them to eat healthily.

People were cared for by kind and attentive staff who knew their needs and preferences for how care and support should be delivered. People told us staff treated them with dignity and respect. Staff gave up their own time to ensure people could follow their personal interests and to support people at difficult times in their lives.

People or those acting on their behalf were involved in the initial assessment and on-going planning of their care. Assessments of people’s needs were undertaken and updated as required to ensure people needs were met. The registered provider had a complaints policy in place that outlined how people could raise complains it and concerns. We saw evidence that when complaints were received the registered provider took appropriate action.

Questionnaires were completed by people who used the service, their relatives and staff, the feedback we saw was consistently positive. A quality assurance system was in place that consisted of audits, checks and feedback. When shortfalls were identified action was taken to improve the level of service as required. The registered manager was involved in the day to day running and management of the service, staff told us they were approachable.