28 September 2022
During an inspection looking at part of the service
Elizabeth Home Care is a domiciliary care agency providing personal care to people in their own home. At the time of our inspection there were 86 people using the service. 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
New systems and processes had been implemented since the last inspection. However, further work was required to embed them and ensure they were fully effective. The systems in place had not always made improvements to the service. For example, we found medication errors and missed calls continued to be inconsistent. Some records were not always accurate, or robust.
At times calls were missed meaning people did not receive the care they required. There was no robust monitoring to prevent missed calls.
Staff had received safeguarding training and procedures had been implemented. People felt safe with the support they received from staff. Accidents and incidents were monitored by the management to ensure prompt referrals were made when required.
Significant improvement had been made to update staff training which was tailored to individual learning styles. Staff received supervisions and told us they felt supported in their roles.
People were happy with the care they received and told us staff delivered care how they wished. People had been involved in the development of their care plans. The provider had made improvements to the care plans, but further work was required to ensure these were always accurate.
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 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 and update
The last rating for this service was inadequate (published 30 March 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection, although some improvements had been made, we found the provider remained in breach of some regulations.
At our last inspection we recommended that the provider implemented procedures for recruitment and duty of candour. At this inspection we found the provider had met the recommendations.
This service has been in Special Measures since 22 February 2022. 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
We carried out announced comprehensive inspection of this service on 25 and 29 November 2021. Multiple breaches of legal requirements were found.
We undertook this focused inspection to check whether the Warning Notice’s we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. And the requirement notices for regulation 11, 13 and 18 had been met. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. 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 Elizabeth Home Care on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to medicines, staffing and 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 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 and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.