Eleanor Nursing and Social Care Ltd - Oxford Office

Eleanor Nursing and Social Care Ltd-Oxford Office is a domiciliary care service offering personal care to people living in Oxfordshire. The service provides support to people living with dementia, learning disabilities or autistic spectrum disorder, physical disabilities, sensory impairment, and mental health issues. At the time of our inspection there were 11 people receiving the regulated activity of personal care from the service.

Not everyone using 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

Staff understood how to protect people from poor care and abuse, and the service worked well with other agencies to do so. There were enough staff, with the appropriate skills, to support people. People received the support they needed to take their medicines. Staff knew how to protect people from infection. The provider had systems to learn from incidents to ensure people were safe.

People received care that met their individual needs and preferences. People's care plans were reviewed and updated regularly to reflect their current needs. People were supported by appropriately trained staff and care records reflected the care they received. People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible. The policies and systems in the service promoted this practice.

The service was responsive to people's needs and wishes. People could request changes to their care, and these were introduced where possible. People received person-centred care which met their needs. Complaints were addressed and feedback was sought from people and their relatives, including their involvement in decisions relating to their care. The provider ensured lessons were learnt from the areas of improvement identified at the last inspection.

The management team was accessible to their teams and encouraged staff to develop skills in order to progress within their work. The management team completed regular audits to ensure the quality of the service and identify areas for improvement. The provider forged positive working relationships with health and social care professionals.

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 requires improvement (published 21 July 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We had carried out an announced comprehensive inspection of this service on 1 June 2022. Breaches of legal requirements had been found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check whether they had followed their action plan and to confirm they now met legal requirements. 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 requires improvement to good. 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 Eleanor Nursing and Social Care Ltd - Oxford Office on our website at www.cqc.org.uk.

Follow up

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

Eleanor Nursing and Social Care Ltd-Oxford Office is a domiciliary care service providing personal care to people living in Oxfordshire. The service provides support to people living with dementia, people with learning disabilities or autistic spectrum disorder, people with physical disabilities, sensory impairment and mental health. At the time of our inspection there were nine people receiving the regulated activity of personal care from the service.

Not everyone using 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

Medicines were not always well managed. Protocols for medicines administered ‘when required’ (PRN) contained confusing and contradictory information. Staff told us the protocols lacked clear guidance regarding administration of medicines. The lack of clear guidance led to one person being overmedicated.

Infection prevention control measures were not always sufficiently embedded and required improvement.

Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. Safe recruitment processes were followed to make sure the right staff were employed.

People's needs were assessed before they were offered a service. However, some care plans did not contain enough information to instruct staff and did not always follow best practice guidance. Staff received a range of training, although some staff members said they needed more training in the management of medicines. People received support with meal preparation, as detailed in their care plan.

People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible. The policies and systems in the service promoted this practice.

People told us staff were kind, considerate and caring towards them. Staff protected people's privacy and dignity and promoted their independence.

People had care plans which were personalised and recorded information on a range of needs. However, some people relatives told us that the information recorded in people's notes was not always accurate. People's communication needs were assessed, and staff were aware if a person required further support with their communication. The service had a complaints procedure which was made available to people being supported. People and their relatives told us they knew how to make a complaint if they had any concerns.

Regular audits were completed into various aspects of the service. However, these had failed to identify the issues found at this inspection such as in relation to PRN protocols or infection prevention control

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

This service was registered with us on 6 December 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 looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted mainly because of concerns received about people not having their care plans in place, missed and late visits, and staff not using PPE properly. A decision was made for us to inspect and examine those risks.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment 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.