Archived: Elm Home Care

Updated 18 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’

This comprehensive inspection took place on 6 November 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit, because it is a small service and the manager is often out of the office supporting staff or meeting with people using the service. We needed to be sure that the manager would be in.

The inspection was undertaken by two inspectors. The inspection site visit activity took place on 6 November 2018. We visited the office location on 6 November 2018 to see the manager, office staff and care staff; and to review care records, policies and procedures. On 7 November 2018 we made telephone calls to people using the service, their relatives and staff.

Before the inspection we reviewed the information, we held about the service. Providers are required by law to notify us about events and incidents that occur; we refer to these as ‘notifications’. We looked at the notifications the provider had sent to us. We also contacted the local authority who monitor and commission services, for the information they held about the service. We used the information that we had gathered to plan what areas we were going to focus on during the inspection.

We spoke on the phone to five people who used the service and five relatives of people that use the service. Whilst at the offices we spoke with four care staff, one care supervisor, the deputy manager and the manager. We spoke to a further two care staff and one care supervisor by phone. We looked at sample of records including four people’s care records, four staff files and training records. We also sampled records that relate to the management and quality assurance of the service, such as survey information from people using the service and complaints information. We looked at quality assurance action plans to understand how the service was using this information to improve outcomes for those using the service.

Updated 18 December 2018

This announced inspection took place at the provider`s offices, on 6 November 2018, with phone calls undertaken to people with experience of the service, on 7 November 2018. The provider was given short notice that we would be undertaking an inspection. This was because it is a small service and the manager is often out of the office supporting staff or meeting with people using the service. We needed to be sure that the manager would be in.

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.

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 and younger disabled adults. At the time of our inspection 15 people were receiving a personal care service from the provider.

Not everyone using Elm Home Care receives a regulated activity; 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.

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

People were supported by staff who were aware of their responsibilities to raise any health and wellbeing concerns. Where safe guarding concerns had been raised these were responded to and appropriately dealt with.

Staff were aware of the risks to people and were provided with risk assessments and care plans to enable them to manage those risks. People were supported to take their medicines as prescribed and competency spot checks were in place to check staff followed the correct procedures.

Staff were provided with the information they needed to support people effectively and meet their needs. People were involved in creating their own care plans, which were detailed and reflected their choices in how the service would be delivered. Supervisors had worked in partnership with people, enabling them to be involved in the training of staff delivering their services.

We heard from people using the service that calls were never missed and happened on time. The service did not have a process for checking if all staff had arrived for the start of their shift. This can lead to people not getting their visit and has the potential to place people at risk of harm. There is also a possible impact on `lone working` staff safety. The service is working on this.

We found that the service recruitment policy was not clear on how DBS, [Disclosure and Barring Service] information should be used. The service is reviewing their policy and procedures.

Staff presented as knowledgeable and skilled in the services they were providing. New staff received induction training and a period of shadowing. There was an ongoing programme of training for all staff. A staff supervision programme was in place and training was a standard agenda item. Staff told us they felt supported and listened to by the supervisors and managers.

People were confident that if they raised a complaint it would be dealt with appropriately. The service kept a record of complaints. Records held inconsistent information and there was not an audit trail in place. There was a lack of analysis of information and therefore trends and improvement service opportunities were missed. The service is working on this.

The manager regularly encouraged people using this service and the staff, to give their views on the service and how it could be improved, with regular survey opportunities. Supervisors regularly visited people as part of the quality assurance process.

A new senior team had been established. Teamwork between managers and staff had driven positive improvements for those using this service, such as an effective communication culture. Managers and staff worked with external agencies, to gain improvements in outcomes for those using this service.

The management team were responsive to advice and feedback given during the inspection.