Elite Support Providers Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always have a proactive and positive culture of safety based on openness and honesty.

We found the provider did not always demonstrate they understood their responsibilities with submitting statutory notifications to CQC. We found 1 record which stated a person sustained a fracture. We raised this with the provider.. Following discussion with the provider, they revised the risk assessment and told us they confirmed there was no information about a fracture from the hospital. This raised questions regarding the accuracy of information recorded within care records and the provider's systems for verifying significant incidents before recording them as confirmed facts.

Staff demonstrated they met each month to review 1 person’s care records and support. There were areas of improvement which had been identified in these meetings and staff discussions demonstrated what actions would be taken and when this would be next reviewed
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

We found initial assessments were completed when people transitioned to the service. The provider told us, “It is like a rapid response, so it is not always possible to get a lot of information. So, we get the referral from the nursing needs assessment [and] get as much information from the family."

People with a learning disability had detailed hospital passports in place. However, we noted these were created after this assessment. We were therefore not assured people had access to hospital passports before this assessment. Hospital passports help healthcare professionals understand a person's health needs, communication preferences and any reasonable adjustments required when accessing hospital services. Health action plans were also in place which detailed people's health needs, what staff should look out for and when to escalate.
 

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

We found staff contacted emergency services when people experienced incidents or reported to be unwell.All staff received safeguarding training and staff were able to tell us when they would raise safeguarding concerns
 

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We found the information contained within 1 person’s care record did not fully and accurately reflect the person's current support arrangements. This created a risk of inconsistent support should staff rely solely on the documented information. For example, 1 person required support with a walking aid. Their risk assessment stated, ‘no mobility aid was documented’, yet staff told us how they supported this person with a walker and sometimes holding their hand. The provider also did not demonstrate how they ensured the person’s walking aid was monitored to ensure this was safe to support people with. Another person required support from staff with repositioning due to risk of pressure ulcers. We found the person’s care records did not demonstrate this was completed to mitigate the risk. This meant people were at potential risk of avoidable harm. The provider had not identified these concerns through their own quality assurance systems
 

The provider did not always detect and control potential risks in the care environment. They did not make sure that equipment, facilities and technology supported the delivery of safe care.

We found environmental risks and equipment requirements were identified within care planning documentation. However, evidence of completed environmental verification and ongoing monitoring was not consistently available within the records reviewed at the time of assessment. This meant potential environmental risks and hazards may not have been identified by staff to safely support people.
 

The provider did not always make sure there was enough qualified, skilled and experienced staff.

Some staff we spoke with were unable to describe the high-risk conditions of people they supported or explain how they would respond if risks escalated. This did not always demonstrate staff had sufficient knowledge of people's needs to ensure risks could be managed safely in a person-centred way.

Furthermore, staff assessing the competencies of other staff administering medicines did not have evidence of appropriate qualifications and experience at the time of the assessment. The provider did not demonstrate how they assured assessors were competent to complete these tasks.

Staff were supported with supervisions and the provider demonstrated wellbeing was also discussed during these meetings. The training matrix demonstrated all staff received regular training across a variety of topics
 

The provider assessed and managed the risk of infection.

Staff told us they had access to personal protective equipment (PPE). Relatives told us staff wore PPE appropriately when delivering care and treatment.There was an up-to-date infection prevention and control policy in place at the time of the assessment. We found the provider also completed regular spot checks with staff and reviewed infection control as part of this.
 

The provider could not demonstrate they always made sure that people’s medicines and treatments were safe and met people’s needs, capacities and preferences.

People’s care plans did not always contain information about which medicines they were taking. For example, we found 1 person’s medicines were managed and administered by their family. However, the person’s health action plan stated that their medicines list "must be verified and attached" to their care record. We found although staff had information about health monitoring and escalation for this person, there was an absence of a documented medicines list within the care planning records we reviewed.

We found 1 person was administered an ‘as needed’ (PRN) medicine regularly. The reasons for administration and outcomes were recorded, however we found some aspects of documentation lacked detail. This meant the provider did not always safely and effectively monitor people’s medicines or maintain oversight of administration.

The staff training matrix showed staff received training in medicine management and received competency assessments