Archived: Elite Homecare

We last inspected this service in July 2017 when we found the registered provider was in breach of Regulations 9, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because care provision was not always reviewed, there weren't adequate systems in place to check on the quality and safety of the service, and not all staff received regular supervision and support. We also found the service was in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009, because the provider had failed to notify CQC of notifiable events. After our last inspection the provider sent us an action plan telling us how they would improve the service. These improvements had been effective, and we found the provider was now compliant with the regulations and consistently meeting people's needs.

Elite Homecare is a domiciliary care agency providing care and support to people living in their own homes. When last inspected, the service offered support to people living in Stockport and Oldham. Following that inspection the provider re-registered the Stockport location as a separate service, so this inspection looked at the services provided by the Oldham Branch of Elite Homecare.

At the time of our inspection 44 people were using the service. The service had a registered manager in place. 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. The registered manager was also the owner and employed a care manager with responsibility for day to day administration of the service.

People who used the service, their relatives and professionals we contacted told us they felt the service was safe. They told us staff took appropriate precautions when delivering care in their homes, and the care staff we spoke with understood their roles and responsibility to safeguard vulnerable people. We saw that where there were risks around peoples care these were assessed, with guidance on how to minimise the risks, but we found sometimes risks associated with people’s behaviour were overlooked.

There were good systems in place to ensure the safe recruitment of staff and there were sufficient staff to attend to people’s needs. Staff were deployed to work with the same people and this meant that they got to know them well. People who used the service confirmed this. They told us that they were treated in an appropriate manner by courteous and kind staff who respected their dignity, and dealt with their personal care issues with sensitivity. Staff received regular supervision to discuss their work, and ongoing training was provided to ensure that they maintained the skills and knowledge required to provide effective support.

Medication policies were appropriate and comprehensive and medicines were administered safely. Staff were knowledgeable about the medicines administration processes. The service had recently revised the way they recorded the administration of medicines to minimise risk and allow for greater accountability. Staff were mindful of the risk of cross infection and ensured they followed good infection prevention and control guidelines.

People’s care records contained information about their preferences and wishes. Care plans included appropriate personal and health information and were up to date. The care staff we spoke with demonstrated an ability to understand the needs of people who used the service and provide person centred care to gauge and respond to changing need.

Staff had received training in the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards and were knowledgeable about this area. People told us that they were offered choices in how their support was delivered, and we saw that staff promoted and supported people’s independence.

There was an appropriate complaints procedure in place and we saw that complaints were followed up in a timely manner.

People who used the service and their relatives spoke favourably about how the service was managed. Staff told us that the service promoted a healthy working environment which helped them to enjoy their job. They told us they felt supported and listened to.

The registered manager and care manager conducted regular audits and checks to ensure the service provided a good quality of care, and to seek ways of improving the service. People who used the service were consulted and completed quality questionnaires to ensure they remained satisfied with the support provided by Elite Homecare.

The service had a registered manager in place. 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.

During the inspection we saw that the registered manager was responsible for the Stockport area and the care manager was responsible for the Oldham area. Information we asked for was readily available for the Oldham area, however this was not always apparent for the Stockport area.

People we spoke with told us they felt safe at the home and people’s relatives also told us they felt people were safe. During our visit, however we identified concerns with the service.

During our inspection we found breaches of Regulations 9, 17 and 18 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014 and of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009, These breaches related to the safety of the governance of the service, person centred care, staffing and not notifying CQC of notifiable events. You can see what action we told the provider to take at the back of the full version of the report.

Each person had a personal care plan that included risk assessments however not all of these had been reviewed regularly.

The service had not notified CQC of all notifiable occurrences which meant they had not always fulfilled their responsibilities in relation to their service and registration.

Elite Homecare had a training and supervision programme in place, however not all staff had received training updates and supervision. Some staff had received support through team meetings however not all staff had been given the opportunity to attend staff meetings.

We found that recruitment practices were in place which included the completion of pre-employment checks prior to a new member of staff working at the service. However we found that not all references had been verified.

Quality assurance systems in place were not robust, we saw that not everyone using the service had received a service review. We asked people if they had been asked their opinions of the service and not all of them had.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. We saw there were policies and procedures in place to guide staff in relation to safeguarding adults and whistleblowing.

The services policies and procedures had been reviewed by the provider and these included policies on health and safety, confidentiality, medication, whistle blowing, safeguarding, recruitment, complaints and lone working. This meant staff had access to up-to-date guidance to support them in their work.

People told us they were very happy with the staff and felt that the staff understood their care needs. People confirmed that staff stayed for the length of time allocated and arrived on time. All of people we spoke with had no complaints about the service. We found that people were involved in decisions about their care and support. We also saw that medications were handled appropriately and safely.

Suitable processes were in place to deal with complaints and people knew the phone numbers to ring and each person we spoke to had no complaints about the service from care staff.