Elmar Home Care Manchester

Elmar Home Care Manchester (previously known as Rectory Gardens) is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 56 people at the time of the inspection, including older people, those living with dementia, people with a physical disability and younger adults.

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

At this inspection we found the service had taken positive steps and implemented systems to improve the quality and safety of the service provided. However further improvements were still required.

We were not assured people always received their medicines as prescribed. The new electronic medicines system did not always provide sufficient detail in respect of people’s medicines. We found not all staff had completed essential training.

The provider had systems in place to monitor the quality of the service and make improvements. However, while there had been some improvements since our last inspection, these systems had not enabled the provider to identify and address the issues we found.

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. However, further work was required in this area. Decision specific mental capacity assessments had not always been carried out to establish if people had the ability to make informed decisions.

Electronic systems were used to record people's care and to monitor risk and ensure scheduled visits took place. Call monitoring of people's support had vastly improved. Further improvements in this area were taking place to ensure staff travel time was appropriate for each visit.

Risks to individuals were assessed and monitored, further work was still needed to ensure this process remained personalised for the person. There were systems in place to ensure lessons were learned and shared with staff when things went wrong.

The service was responsive to people's needs, preferences, interests, and communication needs. People felt involved in the planning and delivery of their care.

Complaints were responded to appropriately. People told us they were aware of how to make a complaint and were confident they could express any concerns which would be addressed.

Staff were aware of how to safeguard people from abuse. Systems were in place to prevent and minimise the spread of infections when supporting people. Pre-employment checks had been carried out to ensure staff were suitable to work with people.

We found the management team receptive to feedback and keen to improve the service. The registered manager and provider worked with us in a positive manner and the information we requested were received in a timely manner.

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 inadequate (published 06 April 2023).

This service has been in Special Measures since 7 March 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating of inadequate. As part of this inspection we also assessed whether the provider had taken the actions necessary to meet the breaches of regulation identified at the last inspection.

The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

Enforcement

We have identified breaches in relation to need for consent, staffing and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Rectory Gardens (known to people as Elmar Home Care) is a domiciliary care agency and provides personal care and support to people who require assistance in their own home. At the time of our inspection there were 113 people being supported by the service.

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

Staffing levels and rota systems were unsafe. People's calls were significantly late, early, short or missed. People and their relatives told us staff were often late or missed calls completely. Pre-employment checks had not been carried out to ensure staff were suitable to support people.

Risks to people were not adequately assessed to keep them safe. Medicines were not safely managed. Medication administration charts were not audited correctly, and action was not taken to address errors promptly.

There was a lack of oversight, scrutiny and governance by the manager and nominated individual. Checks and audits were not effective and / or not completed to monitor the quality and safety of the service. People and staff had provided feedback to the registered manager; however, no action had been taken to analyse this or take any action.

People's care was not planned to ensure staff received guidance on how to provide people with caring, dignified support. Care plans failed to identified people's individual preferences and were generic in nature.

People's needs and choices were not recorded to give staff appropriate guidance to care for them. Staff did not always receive sufficient training to help them carry out their roles. Multiple training topics were covered in one day induction, meaning staff were not provided with enough time to develop their learning.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

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 21 July 2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about a closed culture, allegations of abuse and neglect and poor managerial oversight. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well led sections of this full report.

Enforcement

We have identified breaches in relation to person centred care, need for consent, safe care and treatment, good governance and staffing at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.