Archived: Elizabeth Senior Care Limited

Updated 16 November 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 inspection took place on 24 September 2018 and 2 October 2018 and was announced.

This inspection was carried out by one adult social care inspector.

Prior to the inspection the provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We used this information as part of our inspection planning and throughout the inspection process.

We checked the information we held about the service and the registered provider. This included statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law.

During our inspection we visited four people and their relatives within their homes. We spoke with the registered provider, registered manager, a senior support worker and two support workers.

We spent time looking at records, including three care plan and risk assessment files, four staff recruitment and training files, medication administration records (MARs), daily records, complaints and other records that related to the management of the service.

Updated 16 November 2018

This inspection was undertaken on 24 September 2018 and 2 October 2018 and was announced.

Elizabeth Senior Care Ltd provides care and support to people living in their own homes in and around the area of Ellesmere Port. People were able to access the services of Elizabeth Senior Care Ltd directly. At the time of this inspection the service was supporting and caring for 25 people, enabling them to continue to live in their own homes.

There was a registered manager in place. A registered manager is a person who is registered with the Care Quality Commission 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.

At the last inspection on 20 and 26 June 2017 we found that there were a number of improvements needed in relation to safe care and treatment, staffing and good governance. These were breaches of Regulation 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective Responsive and Well Led to at least good. The provider sent us an action plan that specified how would they would meet the requirements of the identified breaches. During this inspection we found all the required improvements had been made.

Improvements had been made to the medicines systems in place. Staff had all received up-to-date training and had their competency assessed. Medication administration records (MARs) were consistently completed and PRN ‘as required’ protocols were in place. People told us they received their medicines correctly and on time.

Improvements had been made to people’s individual care plans and risk assessments. An initial assessment was undertaken prior to a person receiving support from the service. People’s needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process. The assessment information was used to create risk assessments and person-centred care plans. These documents included clear guidance for staff to follow to ensure people’s preferred routines were followed and preferences met.

Improvements have been made to quality assurance systems. The registered provider undertook regular audits to identify areas for development and improvement at the service. Policies and procedures had been regularly reviewed and updated.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw the registered provider had made improvements since our last inspection. Policies and guidance were in place, the staff had received training and were able to demonstrate a basic understanding. Records showed that consent was sought in relation to care and treatment.

Staff recruitment systems were robust and this helped to ensure the only staff suitable to work with vulnerable people were employed. All staff had undertaken a thorough induction process that included undertaking shadow shifts prior to them lone working. Staff all undertook regular training for their role and refresher updates as required. There were enough staff employed to meet the needs of the people supported.

People had developed positive relationships with the staff that supported them. People told us they had regular staff that visited them. They told us staff treated them with kindness and were caring. People told us their privacy and dignity was respected and their independence promoted.

All staff received support and supervision through the management team. Observations were undertaken to monitor the quality of their work. Staff attended team ‘patch’ meetings and told us they felt well supported in their roles. Staff spoke very positively about the management team.

Staff had all completed safeguarding training and demonstrated a good understanding of what abuse may look like, how they would raise a safeguarding concern and they believed this would be acted upon promptly. Staff were familiar with the safeguarding policies and procedures in place and knew how to access them.

People told us that staff supported them with their food and drink needs. They described being offered choice and we saw clear guidance was in place for staff to follow for people who had specific dietary needs.

The registered provider had a complaint policy and procedure in place. People told us they felt confident to raise a concern and believed they would be listened to and concerns acted upon.

Policies and procedures were available for staff to offer them guidance within their role and employment. These were regularly reviewed and updated by the registered provider