Elite Specialist Care Ltd

Elite Specialist Care Ltd is a homecare agency providing personal care. At the time of this inspection four people received support from the agency.

Care Quality Commission (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

Our previous inspection identified that appropriate risk assessments were not always in place and we found a breach of regulation in respect of this. During this focused inspection, we found that the service had taken action to improve this. Appropriate risk assessments were in place and covered areas such as the environment, physical health and personal care. These also contained guidance for minimising potential risks associated with the COVID-19 pandemic. We found the service no longer in breach with this regulation. However, we discussed with the registered manager that risk management guidance lacked some detail in how to manage the assessed risk.

Our previous inspection found that there were some instances where the service failed to effectively check various aspects of the service and we found a breach of regulation. During this focused inspection, we observed that the service had made improvements and had an effective system in place to monitor the quality of the service being provided to people.

People who used the service told us they were well supported by care workers. Relatives we spoke with confirmed this. One relative said, “[Name] is 100% safe with the carer.”

Policies and systems were in place to safeguard people from the risk of possible harm. Care workers told us that they had received training and report any issues to the registered manager. The service had safe recruitment procedures in place. Currently nobody was assisted with their medicines.

People who used the service and relatives told us that there had been no issues with punctuality or missed care calls.

Care workers we spoke with told us that they felt supported by the registered manager. They told us that management were approachable and they raised no concerns in respect of this. People and relatives confirmed they were involved in their care and feedback was actively sought about the quality of the care provided.

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 requires improvement (published 10 April 2019).

Why we inspected

We previously carried out a comprehensive inspection of this service on 28 January 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led.

The ratings from the previous comprehensive inspection for the key question not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elite Specialist Care Ltd 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.

Not everyone using Elite Specialist Care Limited receives a regulated activity; CQC only inspects the service 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.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

At the last comprehensive inspection we carried out on 27 July 2016 the service was rated Good. We however, found a breach of Regulation 17 Good Governance. The service did not have a system of regular and comprehensive quality audits and checks for monitoring and improving the quality of the service. This may affect the safety and quality of care provided for people. At our responsive inspection on 23 March 2017 we found the service had complied with the requirement made. There were comprehensive audits and checks for monitoring and improving the quality of the service. At this inspection on 8 February 2019, we found some deficiencies related to Safe and Well Led. We have therefore rated the service as Requires Improvement.

People and their representatives informed us that they were satisfied with the care and services provided. They informed us that people were treated with respect and they were safe when cared for by the service. There was a safeguarding adults’ policy and care workers were aware of action to take should they be aware that people were being abused. We however, noted that the safeguarding policy and procedure did not include reference to the role of the DBS.

This was completed during the inspection. The service had a policy for ensuring equality and valuing diversity. Care workers had a good understanding of equality and diversity (E & D) and protecting people’s human rights. They were aware of the importance of treating people as individuals and showing respect for them regardless of their background or individual circumstances.

People’s care needs and some potential risks to them were assessed and guidance provided to care workers on how to care for people. We however, noted that some risk assessments had not been documented for people who needed them. These are required to provide information for care workers and to ensure the safety and welfare of people.

The service had an infection control policy. However, it was not sufficiently comprehensive as it did not contain examples of infectious diseases.

Care workers prepared appropriate and up to date care plans which involved people and their representatives. The service worked well with healthcare professionals to ensure that people’s healthcare needs were monitored and attended to. There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Reviews of care had been carried out to ensure that people received appropriate care.

The service had a policy and procedure for the administration of medicines and people informed us that care workers had supported them with their medicines.

Care workers had been carefully recruited. The necessary checks had been undertaken prior to them starting work. New care workers had been provided with a comprehensive induction and training programme to enable them to care effectively for people. They had support, supervision and appraisals from their manager and a director of the company. Teamwork and communication within the service was good. We however noted that a risk assessment had not been documented for a care worker who needed it. This is to ensure the protection of people who used the service.

The service was working within the principles of The Mental Capacity Act 2005 (MCA). Care workers were aware of the importance of seeking the consent of people or their representatives if people did not have capacity to make decisions for themselves.

Care plans had been prepared with people and their representatives. The care provided had been regularly reviewed. The service had a complaints procedure. No complaints had been recorded. The registered manager stated that none had been received.

Audits and checks of the service had been carried out by senior staff. These included checks on care workers and audits of medicines and care records. We however, noted that these checks and audits were not sufficiently comprehensive as they did not identify the deficiencies we noted. Comprehensive checks and audits are needed so that the service can identify and promptly rectify deficiencies. Satisfaction surveys had been carried out. However, a report following the last survey together with action plans had not been prepared. These are needed to provide details and inform on the findings.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.

At our last comprehensive inspection on 27 July 2016 we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service did not have an effective system in place for auditing and checking the quality of the service. This may affect the safety and quality of care provided for people. After the comprehensive inspection, the registered provider sent us an action plan telling us how they would meet legal requirements. We undertook this focused inspection on the 23 March 2017 to check that they had followed their plan and to confirm they now met legal requirements in relation to good governance.

This report only covers our findings in relation to good governance. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Elite Specialist Care Limited’ on our website at www.cqc.org.uk’.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

At this focused inspection, we found that the provider taken action to comply with good governance. Audits of the service had been carried out by a director of the company. In addition, checks on the quality of care provided by the service had been carried out by the director and the registered manager. These included spot checks on care workers and reviews of the services provided.

A satisfaction survey had been carried out. People who used the service expressed confidence in the management of the service.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People and their representatives informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they were safe when cared for by the service. There was a safeguarding adults policy and suitable arrangements for safeguarding people from abuse.

Care workers were caring in their approach and knowledgeable regarding the individual choices and preferences of people. People’s care needs and potential risks to them were assessed and guidance provided to care workers on how to care for people. Care workers prepared appropriate and up to date care plans which involved people and their representatives. The service worked well with healthcare professionals to ensure that people’s healthcare needs were monitored and attended to. This was confirmed by professionals we contacted.

There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Reviews of care had been carried out to ensure that people received appropriate care. The service had a policy and procedure for the administration of medicines. However, we were informed that none of the people using the service needed assistance with their medicines.

Care workers had been carefully recruited. the necessary checks had been undertaken prior to them starting work. New care workers had been provided with a comprehensive induction and training programme to enable them to care effectively for people. They had the necessary support, supervision and appraisals from their managers. Teamwork and communication within the service was good.

People and their representatives expressed confidence in the management of the service. They stated that care workers communicated well with them and kept them informed if they were held up or running late. Care workers were aware of the values and aims of the service and this included treating people with respect and dignity, providing high quality care and promoting people’s independence where appropriate.

Complaints made had been promptly responded to. Two healthcare professionals provided positive feedback regarding the management of the service. They indicated that the service was well organised and there was good communication with the service regarding the progress of people.

The registered manager stated that checks of the service had been carried out regularly by their Field Supervisor. These included spot checks on care workers, reviews of care and risk assessments. Evidence of these were provided. We however, noted that there was no evidence of regular audits being carried out. There was no written evidence of regular audits in areas such as complaints, policies and procedures and punctuality of staff. Comprehensive audits are needed so that the service can identify and promptly rectify deficiencies.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.