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Enigma Clinical Solutions Ltd

Overall: Good read more about inspection ratings

Pure Offices, 137 Pastures Avenue, St. Georges, Weston-super-mare, BS22 7SB (0117) 450 4821

Provided and run by:
Enigma Clinical Solutions Ltd

All Inspections

During an assessment under our new approach

Date of Assessment: 23 April to 12 May 2026.

Enigma Clinical Solutions Ltd is a care at home service. It provides personal care and support to people in their own homes. At the time of our assessment Enigma Clinical Solutions Ltd provided support to 64 people. 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.

We carried out this assessment to review actions taken by the provider following our last inspection. The previous report was published in March 2023. At that time, the service was rated requires improvement in all key questions and overall. There were breaches of regulations relating to person centred care, safe care and treatment and good governance.

In this assessment, we reviewed all quality statements under all key questions. We found improvements had been made and the provider was no longer in breach of regulations. The ratings for these key questions have changed to good. The overall rating for the service has changed to good.

Improvements had been made to ensure information in care plans was more detailed and personalised. We found some inconsistencies in some records, but these were addressed promptly and people and relatives told us they were involved in assessments and decision making. They said staff knew them well and usually delivered support in the way they preferred. Staff used care plans routinely in their work and felt these contained the necessary information to enable them to provide person centred care.

During our last inspection we found risks were increased because people did not always receive safe care and treatment and medicines were not always managed in accordance with national guidance. At this inspection, we found improvements had been made and information about risks such as falls, choking and skin integrity was consistently documented. Systems were in place to ensure medicines were effectively managed.

More effective governance structures and oversight had been put in place since the last inspection. The provider had engaged an external compliance consultant to support them. The quality and safety of the service was regularly monitored and a wide range of audits helped managers check the service provided was safe, effective and being delivered as it should be. During the inspection, we discussed changes which would improve the accuracy and effectiveness of some audit tools.

29 November 2022

During a routine inspection

About the service

Enigma Clinical Solutions Ltd is a domiciliary care service providing personal care to adults with a range of support needs including people living with dementia. At the time of the inspection the service was providing personal care to 12 people living in their own homes in the local community.

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 and their relatives told us the service was not always well managed. We found shortfalls with the management of people’s risks, medicines, person centred care and quality assurances systems which placed people at increased risk of harm.

The service had systems in place to monitor the quality and safety of the service, however they did not identify the issues we found during the inspection.

Some risks to people had not been sufficiently assessed and documented in their care records. Where people received support with medicines, this was not managed safely in line with national guidance.

People and relatives told us care visits were often late and people were not kept updated when delays occurred. We found people’s care plans were lacking in personalised information. People and their relatives told us staff were not always sufficiently skilled and knowledgeable.

People and their relatives told us staff were mostly kind and caring, however staff interactions with people were limited. We received mixed feedback as to whether staff maintained people’s dignity and independence.

Staff spoke positively of their work and told us there was good communication with managers. People were supported by staff who had completed training and felt well supported by the management team.

People were supported by staff who had been assessed as safe to work with vulnerable adults and who understood their responsibility to report any concerns.

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.

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 20 September 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, person centred care and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

We have made recommendations about monitoring care visits and the management of complaints.

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.