We carried out an inspection of Elite Care on 1 and 2 September 2016. This was an announced inspection where we gave the provider 48 hours’ notice. This was because the location provides a domiciliary care service and we wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf. Elite Care provides a range of services to people in their own home including personal care, companionship, help with light household duties and shopping in Salisbury and the surrounding areas. At the time of inspection there were 51 clients using the service.
A registered manager was in place and available throughout the inspection. 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 who used the service told us they felt safe. Staff had received training about safeguarding and knew how to respond to any allegation of abuse. Staff were aware of the whistleblowing procedure which was in place to report concerns and poor practice. People told us they felt confident staff would always arrive and would usually be informed if staff were going to be significantly delayed. People and staff told us it was not always possible for staff to arrive on time as there was often no allowance for journey times between visits. This meant that some visits were shorter than scheduled.
People said they saw regular staff although said this was not always the case at evenings and weekends when there were less staff available. During these times, other staff working for Elite Care would be asked to work additional shifts which meant people did not always see the same staff who usually cared for them.
People said they were satisfied with the support they received with regards to their medicines however; medicines were not always managed safely. The Medicines Administration Records (MAR) did not always provide sufficient information to enable the safe administration of medicines and documentation of medicines administered was not consistently completed. This meant people were at risk of not receiving their medicine as prescribed and according to the labelling.
People and their relatives spoke highly of the staff and said they always treated them with consideration and respect. Staff spoke about how they helped people retain their independence and encouraged them to be in control of their decision making and choices. People said they were cared for in a person centred way and said their regular staff knew them well. Staff spoke fondly about the people they supported and gave good examples of how they developed positive relationships with people using the service. People, their relatives and staff gave examples of when staff had gone the ‘extra mile’ to help and support people.
Systems to manage risk and ensure people were cared for in a safe way were not always effective. Although people had risk assessments in place and actions on how to monitor identified hazards and concerns, some actions had not been recorded to show that these risks had been reduced or managed. This meant there was a risk that people’s safety and well-being was not always protected.
Staff completed competency assessments as part of their induction followed by regular supervisions and training. Staff were knowledgeable about people’s needs and said they received the necessary training to equip them with the skills they needed to provide the care people required.
Staff had received training around the Mental Capacity Act 2005. Staff explained they understood the importance of ensuring people agreed to the support they provided.
Staff helped ensure people who used the service had sufficient food and drink to meet their needs. Some people were assisted by staff to cook their own food and other people received meals that had been prepared by staff.
People had access to health care professionals to make sure they received appropriate care and treatment. The service maintained accurate and up to date records of people’s healthcare and GP contacts in case they needed to contact them.
Staff were knowledgeable about people’s care and support needs. Care plans detailed how people liked to be cared for and were person centred. There were regular visits and spot checks carried out by management to monitor the quality of service and the care practice carried out by staff.
A complaints procedure was available and people we spoke with said they knew how to raise a complaint if they needed to. Complaints and concerns were handled in an appropriate way.
Staff were passionate about providing good quality care and said they felt supported by the management team. There was an open door culture and staff said the management team were very approachable.
People had the opportunity to give their views about the service. There was regular consultation with staff, people and/or family members and their views were used to improve the service. Quality audits were completed to monitor service provision and to ensure the safety of people who used the service and outcomes communicated to staff during regular team meetings or newsletters. However, findings from a recent internal medicines audit which highlighted issues with administration of medicines had not been fully addressed.
You can see what action we told the provider to take at the back of the full version of the report.