Archived: Everlasting Healthcare Services Limited

Improvement action plan issued following the previous inspection

Where we asked the provider to complete an improvement action plan following the last inspection, include the text below, adapting where necessary:

'Following the last inspection, what they would do and by when to improve the key question(s) to at least good.' Then describe at a high level what you found, adding detail in the detailed findings section for the relevant key question(s).

Focused inspection

'We undertook an announced / unannounced focused inspection of on . This inspection was done to check that improvements to meet legal requirements planned by the provider after our inspection had been made. The team inspected the service against of the five questions we ask about services: is the service well led, , (more as needed)? This is because the service was not meeting some legal requirements.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection'

Comprehensive or focused inspection

Where breach topic has moved to a different key question in Next Phase

When we completed our previous inspection on DD/MM/YYYY we found concerns relating to . At this time this/these topic area(s) was/were included under the key question of . We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework this/these topic area(s) are included under the key question of . Therefore, for this inspection, we have inspected this key question and also the previous key question of to make sure all areas are inspected to validate the ratings.

Provide a brief overview of the service (e.g. Type of care provided, size, facilities, number of people using it, whether there is or should be a registered manager etc).

Service Types and descriptions

Care at Home services

Domiciliary care agency

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community [and specialist housing]. It provides a service to [older adults], [younger disabled adults], [children].

Provider of care to people living in specialist housing

Location proving care to people housed under supported living arrangements

This service provides care and support to people living in [a] [insert number of] 'supported living' setting[s], so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Location proving care to people living in extra care housing

This service provides care [and support] to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is [bought] [or] [rented], and is the occupant’s own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care [and support] service.

Describe the specialist housing setting[s] people live in, there are some examples below:

People using the service lived in…

[number] ordinary flats and bedsits across [town/city/area]

a single 'house in multi-occupation' shared by [number] people

[number] of [bedsits], [flats], [houses], [and] ['houses in multiple occupation'] across [town/city/area]

a large gated community on the outskirts of [city]

Where the service supports people living in houses in multiple occupation (HMOs), add:

Houses in multiple occupation are properties where at least three people in more than one household share toilet, bathroom or kitchen facilities.

Give a summary description of the houses, the facilities that are shared, and either the number or the range of numbers who share them. Include information about any office or sleep in arrangements. Give less detail and more summarised information where larger numbers of HMOs are supported.

Do not provide a detailed, estate agent style description of the premises lived in by people using the service; only an outline summary able to broadly explain the context in which it provides regulated activity

All Care at Home services

Where needed, explain that not everyone using the service receives personal care, for example:

Not everyone using [service name] receives 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.

Residential care home

[Care home name] is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Describe the care home's premises, for example:

(The care home) accommodates xx people in one adapted building.

(The care home) accommodates xx people across three separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia.

Do not provide a detailed, estate agent style description of the premises; only an outline, broad summary.

Services for people with learning disabilities and autism

'The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.' Registering the Right Support CQC policy

You will need to reflect where a service does not conform to Building the Right Support and Registering the Right Support guidance. It is very difficult for large services for people with autism to meet the standards.

Complex or multiple service location

If you are inspecting a complex, multiple service type location you will need to adapt and edit the above paragraphs as needed, probably substantially.

N.B. If there is or should be a registered manager include this statement to describe what a registered manager is:

'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.'

Give a summary of your findings for the service, highlighting what the service does well and drawing attention to areas where improvements could be made. Where a breach of regulation has been identified, summarise, in plain English, how the provider was not meeting the requirements of the law and state 'You can see what action we told the provider to take at the back of the full version of the report.' Please note that the summary section will be used to populate the CQC website. Providers will be asked to share this section with the people who use their service and the staff that work there.

Everlasting Healthcare Limited was registered in February 2015 to provide personal care and support for adults in their own homes. The service is currently small providing home care support locally. At the time of our inspection the service provided care and support to seven people.

The service is required to have a registered manager in post. 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. A registered manager was in post at the time of our inspection.

The service was not always consistently safe because some of the risk associated with people’s care needs had not at all times been assessed or recorded effectively. Whilst people were included in the planning and review of their care; their care plans and risk assessments did not always reflect their individual needs to ensure they received person-centred care. People felt safe and staff were aware of what would constitute abuse and knew how and who to report it to. The provider had processes and systems in place that kept people safe and protected them from the risk of abuse.

The provider's recruitment processes ensured staff were safely recruited. People felt staff had the skills and knowledge to care and support them in their homes. Staff completed a training induction programme and received on-going training that ensured they had the knowledge and skills to enable them to care for people in a way that met people’s individual needs and preferences. Where appropriate, people were supported to access health and social care professionals.

People were supported to make choices and were involved in the care and support they received. People's rights were protected because staff, including the registered manager understood their responsibilities related to the Mental Capacity Act 2005 and the associated Deprivation of

Liberty Safeguards. The provider knew what appropriate action should be taken to protect people’s legal rights.

Staff was caring and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support needs. People, relatives and staff felt they could speak with the provider about their worries or concerns and felt they would be listened to and were confident the provider would take appropriate action where required.

Systems in place to assess and monitor the quality of the service provided to people were not always used effectively to identify or manage risks. The planning and scheduling of visits required some improvement as people who used the service regularly experienced late calls.