East Office

East Office is a domiciliary care agency registered to provide personal and nursing care to people living in their own homes. Most people due to the complexity of their care and treatment needs had 24/7 care, or care for a large proportion of the day and night.

The service is able to support children up to 18 years of age, younger and older adults, people with a learning disability or autistic people, and people living with dementia, a physical disability and/or sensory impairment. At the time of the inspection, 39 people were using the service, all of whom received personal, and/or nursing, care.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone whose primary care need was for a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support

Staff were knowledgeable and skilled in applying safeguarding procedures and knew to whom they could report any concerns. The provider acted effectively where safeguarding issues or allegations were identified. People received their medicines as prescribed by trained and competent staff.

The service and the staff team took on board learning when things went wrong and effective changes were implemented. Enough skilled and suitable staff had been recruited and most recruitment records showed the provider had checked they were safe to work with people. However, best practice guidance for checks for staff from outside the UK did not always include a police check. We were assured this would be addressed. A relative said there was enough staff cover, and only in exceptional circumstances did they have to support their family member's care needs until replacement staff arrived.

Right Care

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. A person told us they chose when to have their medicines and how. Other professionals were involved so people’s care and treatment was always in their best interests.

Risks to people were identified and safely managed. Staff knew how to keep people safe, such as when using medical equipment and hoist and slings used to support people to reposition. Staff adhered to good infection prevention and control practices. A person told us staff always washed their hands between each care task.

Right Culture

In the main, quality monitoring systems, oversight and governance was effective in driving improvements. Although there were some missed opportunities to improve the accuracy and details in people’s records. The registered manager led by example and had fostered an open and honest staff team culture. Staff put people’s needs at the forefront of their care and treatment needs and staff upheld people’s human rights to have a good quality of life.

People, their relatives and staff had a say in how the service was provided. The provider worked well with other organisations, and this helped people live a full meaningful life. A person had praised the provider for standing up for their human rights so they could live more independently at home. Another person had, for the first time ever, been on a holiday which they had thoroughly enjoyed.

Why we inspected

The inspection was prompted in part due to concerns we received about safeguarding and risks to people, the culture and management of the service. A decision was made for us to inspect and examine those risks. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led section of this report. The overall rating for the service has remained good. This is based on the findings at this inspection.

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 (published 29 April 2022).

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

East Office is a domiciliary care agency registered to provide personal, and nursing, care to people living in their own homes. The service is able to support children up to 18 years of age, people with a learning disability or autistic spectrum disorder, older people some of who were living with dementia and people with a physical disability. At the time of the inspection, 47 people were using the service, all of whom received personal, and/or nursing, care.

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

Staff knew how to safeguard and support people to keep them safe. People received their medicines as prescribed and staff ensured they followed infection prevention guidance. The service and the staff team took on board learning when things went wrong and effective changes were implemented.

Enough skilled and suitable staff had been safely recruited. People were supported by a consistent staff team who they felt comfortable with. However, some people were dissatisfied when people’s care was shared with other care agencies or external healthcare professionals. Staff had received the required training and ongoing support to help them maintain and improve their skills to fulfil their role and responsibilities. People said their regular staff team had the skills necessary to care for them well.

People's needs were assessed before the service provided them with care or support. Staff knew people's needs well and care plans were reviewed as soon as changes occurred. Staff had received the required training and ongoing support to help them maintain and improve their skills to fulfil their role and responsibilities. People said staff had the skills necessary to care for them well.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People said staff were caring and knew their needs and preferences well. Staff gave people privacy, treated them with dignity and respect and helped promote people's independence.

People said they were involved when reviewing their care and felt staff were responsive to their changing needs.

Monitoring and oversight of the service was effective in identifying and driving improvements. The registered manager led by example and had fostered an open and honest staff team culture. People came first and foremost, and they had a say in how the service was provided. The provider worked well with other organisations, to provide people with joined up care.

Why we inspected

This inspection was triggered due to concerns about people's safety, staffing levels, staff skills and missed care visits. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective and Well-led sections of this full report.

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 (published 26 November 2019).

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.

East Midlands Office – Apollo Home Healthcare Ltd is a domiciliary care agency providing personal care to people of all ages at the time of the inspection. There were 29 people using the service at the time of our inspection.

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.

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

People felt safe using the service because staff knew what they were doing, they had been trained, and cared for people in the way people wanted. Staff assessed and reduced risks as much as possible, and there was equipment in place to help people remain as independent as possible. There were enough staff, and the senior staff also spoke with people regularly. The provider obtained key recruitment checks before new staff started work.

People received their medicines and staff knew how these should be given. Medicine records were completed accurately and with enough detail. Staff supported people with meals and drinks. They used protective equipment, such as gloves and aprons. Staff followed advice from health care professionals and made sure they asked people’s consent before caring for them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People liked the staff that cared for them. Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected. Staff worked well together, they understood the service’s aim to deliver high quality care, which helped people to continue to live as independently as possible.

Staff kept care records up to date and included national guidance if relevant. Complaints and concerns were dealt with and resolved.

Systems to monitor how well the service was running were carried out. Concerns were followed up to make sure action was taken to rectify any issues. Changes were made where issues had occurred, so that the risk of a similar incident occurring again was reduced. People were asked their view of the service.

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

Rating at last inspection

This service was registered with us on 07/09/2018 and this is the first inspection.

Why we inspected

This was the first inspection of this service based on the registration date.

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.