Eleanor Nursing and Social Care Ltd - Bexley Office

Updated 20 April 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection site visit was carried out by a single inspector. Two inspectors made calls to staff and two Experts by Experience made calls to people using the service and or their families. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also wanted the registered manager to seek consent for us to speak with people and their families.

What we did before the inspection

The inspection was prompted due to concerns received by the local authority which were shared with us.

We checked the information we had about the service including notifications they had sent us. A notification is information about incidents or events that providers are required to inform us about. We asked the local authority commissioning and safeguarding teams for any information they had about the service

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager, a care coordinator and operations director on the site visit and with another care coordinator and two supervisors by phone following the site visit. The experts by experience made phone calls to six people and 13 relatives on the 1st and 2nd March 2021. A second inspector made calls to seven care staff on the 1st and 2nd March 2021.

We reviewed a range of records. This included 11 people’s care records, 11 medication records and care notes. We looked at seven staff recruitment records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We requested records such as risk assessments, care plans and quality assurance records to be sent to us for review.

Updated 20 April 2021

Eleanor Nursing and Social Care Ltd - Bexley Office is a domiciliary care service in the London Borough of Bexley, providing personal care and support to people living in their own homes. The service also supports people under a discharge from hospital scheme. Some people using the service have longer term packages of care and support.

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.

At the time of the inspection the service was providing personal care to 92 people, most of whom were aged 65 and over.

People’s experience of using this service and what we found

Medicines were not always safely managed. Most risks to people were assessed. However, there were risks in relation to epilepsy and behaviour where staff did not always have sufficient guidance.

Systems and procedures to monitor the quality and safety of the service in relation to medicines, call scheduling, wearing of PPE and the monitoring of Covid-19 testing for staff did not always operate effectively.

There were enough staff to meet people’s needs but call scheduling did not always allow for travel time between visits. We had mixed feedback from people about the timing of care and support provided and if staff stayed the full length of the call.

People told us they felt safe using the service and that staff were kind and caring and attentive to their needs. Staff were familiar with safeguarding procedures and where to raise any concerns.

Staff had received training on infection prevention. The provider had updated policies and processes in place to reflect current guidance on Covid-19 and developed initiatives to reassure and support staff during the pandemic.

Staff were positive about the registered manager and provider about the way they managed the service and supported them.

Most people and their relatives said they were consulted about their needs and wishes and thought the service was well run and that any issues they raised were addressed. Their views about the service were sought through telephone monitoring, spot checks and surveys.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (report published 14 December 2018).

Why we inspected

The inspection was prompted in part due to concerns we received from the local authority about a number of complaints they had received about the service. These related to short or late calls and some staff not wearing appropriate PPE. A decision was made for us to carry out a focused inspection of Safe and Well-Led to examine those risks.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from the concerns found. The registered manager took action to address some of the issues highlighted following the inspection, including improving the systems to record staff Covid-19 tests and call scheduling.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eleanor Nursing and Social care Ltd – Bexley office on our website at www.cqc.org.uk.

Follow up

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.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety.