We carried out a review of the data available to us about ELMS Health Solution on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about ELMS Health Solution, you can give feedback on this service.
ELMS Health Solution is a domiciliary care agency providing support to seven people of which five were receiving personal care. This service is provided to older people, those living with dementia, learning disability or autism, physical disability or people with 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.
People’s experience of using this service and what we found.
Staff used their knowledge about keeping people safe from harm people to good effect. There were proactive procedures and systems in place to help prevent incidents occurring. The provider recruited and deployed sufficient suitable staff in a safe way. There were effective systems and policies in place to promote good standards of infection prevention and control. Risks were identified and managed well. Medicines were administered and managed safely. One relative told us, "Staff use the [equipment] very carefully and safely to reposition my [family member]. I trust staff implicitly."
People's assessed needs were met by staff with appropriate skills and whose induction, supervision and training was kept up-to-date. The registered manager engaged well with others involved in people's care. People were supported to eat and drink enough. Staff used their knowledge about health conditions by seeking timely support from health professionals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff supported people with kindness, compassion and tenderness. Staff promoted people's independence and upheld their privacy and confidentiality. Advocacy support was provided for people. People had a say in developing their care, how it was provided and by whom.
People's care was person centred and based on areas of people's lives important to them. One relative said, "Staff are meticulous in everything they do, even down to the finer points [of care]. I could not manage a single day without them." Concerns were resolved before they became a complaint. Compliments were used to identify what worked well. People were supported with end of life care in a dignified and compassionate way.
The registered manager used effective audits and oversight of the service and made improvements. A team of staff who upheld the provider's values worked well together with others. People, relatives, health professionals and staff had a say in how the service was run. The provider was displaying their previous inspection rating correctly, and we had been told about incidents such as when people had passed away.
Rating at last inspection.
The last rating for this service was requires improvement (published 21 February 2019).
Why we inspected
This was a planned inspection based on the previous inspection rating.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
This inspection took place on 17 and 18 January 2019. The inspection was announced. This is the first Care Quality Commission (CQC) inspection since the service registered on 22 January 2018.
Not everyone using ELMS Health Solution received 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 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.
Trained staff prompted people to take their prescribed medicines. However, people’s medicines’ administration records lacked guidance for staff on whose responsibility it was to order, collect and dispose of people’s medicines. This increased the risk of people missing their regular prescription.
Staff understood their duty to report concerns to protect people from the risk of poor care and harm. People had risk management plans to provide guidance and information for staff on how to reduce and monitor assessed risks to their health and welfare. However, although staff knew people’s risks and care support needs, people’s documented risk assessments and care plans were not always up-to-date. Within the office, people’s care records were held securely to ensure confidentiality.
Staff had recruitment checks completed on them prior to starting work at the service. However additional checks carried out to ensure a potential new staff members suitability were not always documented.
The registered manager responded to concerns and resolved these where possible. The registered manager led by example and encouraged an open and honest culture within their staff team. Audit and governance systems were in place so that they could drive forward any improvements required. However, we found that this oversight was not always as effective as it could have been. This is because areas found during this inspection requiring improvement, had not been identified. The registered manager and their staff team linked up and worked with other organisations to ensure people’s well-being.
One notifiable incident had not been sent to the CQC promptly. The registered manager put actions in place to improve this for any further such occurrences. A notification is information about important events that the law requires the provider to notify us about such as safeguarding concerns, deaths, and serious incidents.
People’s care was consistently provided at a time and duration they expected. Staff treated people with compassion and kindness. Staff maintained people’s privacy and dignity when supporting them with their personal care. Staff helped people, where needed, with their eating and drinking to promote well-being.
People had technology and equipment in place to help staff assist them to receive safe care and support. The registered manager, when things did not go as planned, took actions to prevent these events from happening again.
Staff had training to meet people’s care and support needs. To develop staff, supervisions and competency ‘spot checks’ were in place.
Staff maintained good infection prevention and control practices when supporting people including wearing personal protective equipment such as aprons and gloves.
People and their families were involved in their or their family members care decisions. Staff promoted people’s independence as far as practical. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
Systems, policies and procedures were in place should any person need end of life care or support. This was planned to make sure people’s care was dignified and comfortable.
Further information is in the detailed findings below.