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Essex Cares Mid Good Also known as Domiciliary Support & Reablement Service Chelmsford & Maldon

Inspection Summary

Overall summary & rating


Updated 7 December 2017

This comprehensive inspection took place on the 9 and 10 of October 2017. We last inspected the service in October 2016, this was following the service being rated as Inadequate in March 2016 and being placed in special measures. In October 2016 we found that the service had made improvements and they achieved a rating of requires improvement without any breaches of the Health and Social Care Act, 2008; 2015.

During this inspection, we found that the provider had significantly improved the culture and the running of the service. Improvements to the service had been sustained and there were elements of the service that were outstanding and we found that the service was “Outstanding” in the Well-led domain. The provider had plans in place to ensure that they continuously learnt, improved, and evolved as a service and they were now providing a service based on core shared values that were visible at all levels of staffing. This meant that the provider had created a firm foundation to work towards providing outstanding services in all areas.

At the time of inspection Essex Cares Mid were providing short, six week care to 38 people in their own homes. This was a new contract and the service worked within local hospitals, and with the local authority to support people leaving hospital until a permanent care package could be found or people were able to manage independently without support.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People receiving a service could be assured that they were receiving care provided by staff that had an excellent understanding of individual risks and needs. Staff were recruited safely and had undergone a values based assessment to ensure that their own values matched that of the organisation. Staff had an excellent understanding of safeguarding vulnerable people.

Staff were trained to safely manage medications and peoples complex physical and mental health needs. The registered manager and health care professionals provided care staff with the tools and information they needed to provide safe care.

The provider had revised and developed training for all staff according to the changes to people’s physical and mental health needs. This ensured that care staff had the appropriate skills and knowledge to care for people effectively. People told us that staff had an excellent understanding of how to care for them.

Staff, managers, and the provider had very good understanding of the Mental Capacity Act, 2005. Clinical records evidenced that staff supported people’s wishes and preferences and they supported and encouraged and respected them.

The registered manager had excellent links with other health professionals within hospital and social care settings, working together to source the best care options for people referred to the service. Staff had access to a physiotherapist and occupational therapist. They were on hand to offer advice and support regarding peoples changing physical needs and equipment needs.

People told us that staff were caring and considerate and treated them with compassion. Staff promoted person centred care at all levels of seniority to ensure the best outcomes for people. People told us that staff treated them in a respectful and dignified way at all times.

People were involved in all aspects of their care. Care plans and risk assessments were thorough and focused on people’s individual goals, needs, and risks. The registered manager actively sought people’s views of their care at regular intervals and where people had complained about the service, the manager had acted appropriately and respectfully to investigate and provide a meaningful resol

Inspection areas



Updated 7 December 2017

The service was safe.

Staff were recruited to work for the service safely and a thorough induction ensured that staff were able to provide safe care.

Staff had an excellent understanding of safeguarding vulnerable adults and the service reported all concerns appropriately and in a timely way.

The registered manager thoroughly investigated incidents and accidents, overseen by the quality and governance team to ensure lessons were learnt.

Medicines were managed safety and staff received regular training and supervision in practice to ensure they were safe to administer medicines.



Updated 7 December 2017

The service was effective.

Staff received an excellent range of training and development opportunities that changed depending on the needs of people using the service.

Staff received regular supervision and support to ensure that they could continue to carry out their duties effectively.

The service had developed excellent links to health and social care professionals and had employed a physiotherapist and occupational therapist to support staff to achieve the best possible health outcomes for people.

All levels of staff had an excellent understanding of the Mental Capacity Act 2005.



Updated 7 December 2017

The service was caring.

People told us that staff were caring and considerate and promoted their independence at all times with a dignified and respectful approach.

The registered manager made significant efforts to ensure that people and staff felt cared for by the organisation.

People were treated equally and their diversity respected and supported.



Updated 7 December 2017

The service was responsive

People had allocated keyworkers who completed care plans and assessments with them and who regularly reviewed these.

Care plans and assessments were thorough and person centred focusing on individual goals.

The registered manager had various forums for collecting information from people about the service provided.

When staff identified errors, or investigated complaints, responses were thorough and the registered manager and service provider were open and transparent about lessons learnt.



Updated 7 December 2017

The service was outstandingly well led.

The registered manager and Quality and Governance team had worked tirelessly to overhaul systems and processes that had previously failed.

Managers and staff had made significant improvements in line with best practice guidance, including NICE guidance.

The provider had an excellent oversight of the service and was open, transparent, and supportive.

The chief executive for the organisation personally reviewed and signed letters of apology and duty of candour when errors had been identified.

People and all staff told us that the registered manager was approachable, encouraging, and supportive.

The registered manager acted as a safe, effective, caring, and responsive role model for junior staff.