Elite Livein Care Limited

Updated 6 December 2023

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors and an Expert by Experience. 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.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period notice of the inspection because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 9 October 2023 and ended on 24 October 2023 We visited the location’s office/service on 11 October 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We used information gathered as part of monitoring activity that took place in July 2023. We used all this information when planning the inspection.

During the inspection

We spoke with 4 people and 5 family members about their experience of the care provided. We spoke with the registered manager, deputy manager and six care team members. We received feedback from 3 external health or social care professionals.

We reviewed a range of records. This included 6 people's care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including, training, quality monitoring, policies and procedures were also reviewed.

Updated 6 December 2023

About the service

Elite Livein Care Limited is a domiciliary care service providing personal care to people in their own homes. The service provides support to older people and younger adults some of whom may be living with dementia, and/or a physical disability or sensory impairment, mental health need or have a learning disability or autism. People receive 24-hour support provided by live in care staff. At the time of our inspection there were 35 people using the service living in Hampshire and the surrounding areas.

Everyone who used the service was receiving 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

We received positive feedback from people or their family members about the service they were receiving. Everyone spoke highly of the care staff, senior staff and the registered manager. People felt they were cared for with kindness and compassion and their independence was promoted.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there was a person using the service who has a learning disability and or who was autistic.

People were usually supported to have choice and control of their lives. However, we found some restrictions were in place and formal systems as required by mental capacity legislation had not been completed to assess people's mental capacity and ability to consent to care or restrictions.

Most risks to people were assessed, recorded in care plans and updated when people's needs

changed. The registered manager took prompt action when we identified some further risks that required assessment and mitigation plans/guidance for care staff to be put in place. Medicines were generally managed safely and the registered manager took prompt action to improve some aspects of medicines record keeping.

There were systems in place to monitor the quality of the service however, these had not identified the failure to follow formal Mental Capacity and best interest decisions procedures or ensure all risk assessments and record keeping regarding medicines were in place.

People told us they had been involved in care planning and care plans generally reflected people's individual needs and choices. Staff were responsive to people's needs, which were detailed in care plans.

People told us they felt safe and secure when receiving care. People were supported to meet their

nutritional and hydration needs and staff contacted healthcare professionals when required. Staff followed all necessary infection prevention measures.

Safe recruitment practices were followed and appropriate checks were undertaken, which helped make sure only suitable staff were employed to care for people in their own homes. There were enough care staff to meet the needs of people being supported by the service. Staff told us they felt supported, received regular supervision and training.

People benefitted from a management and staff team who were committed to ensuring they received a service which was caring. People, family members and care staff had regular contact with the registered manager who they felt able to approach should the need arise. People and staff were confident the registered manager would listen to them and take any necessary action.

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

Rating at last inspection and update

The last rating for this service was good (published 21 August 2017).

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence the provider needs to make improvements. The registered manager took prompt action to make the necessary improvements. Please see the effective and well-led sections of this full report.

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

Why we inspected

This inspection was prompted due to the time since the previous inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elite Livein Care Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to Mental Capacity and best interest decisions at this inspection. We have also recommended that the provider review their record keeping and quality assurance procedures.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.