Background to this inspection
Updated
26 April 2024
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
This inspection was carried out by 2 inspectors. An Expert by Experience also made telephone calls to relatives to gain their feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service a short period of notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and formal notifications that the service had sent to CQC. Notifications are information that registered persons are required to tell us about by law that may affect people’s health and wellbeing. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke to 4 people using the service and 7 family members as well as visiting and speaking with 4 people in their homes. We also spoke with the registered manager, manager and 3 care staff. We reviewed a range of records including 4 people’s care plans and risk assessments, 3 people’s medicines records, 3 staff recruitment records, auditing processes, training records and other documentation that supported the running of the service.
Updated
26 April 2024
About the service
Elegant Excellency Health and Social Care Services Ltd is a domiciliary care agency providing personal care to people living in their own homes. The agency worked with younger adults and older people who may have dementia and/or physical disabilities. At the time of our inspection there were 14 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
People and relatives told us they were happy with the care provided by the service and felt it was responsive to their care and support needs.
Despite the positive feedback from people and relatives, we found significant concerns. People’s personal risks were not always assessed. Where risks were assessed, this was inconsistent. Risk assessment documents did not always provide adequate guidance to staff. Staff recruitment was not robust and appropriate background checks and information was not always sought. People’s care plans were inconsistent and were not always person centred. Medicines were not always well managed and appropriate recording mechanisms were not in place. Auditing systems failed to identify the issues found during this inspection.
We have made a recommendation around care planning.
Staff had received training on safeguarding and understood how to report any concerns. People received their medicines safely and on time. There was good oversight of medicines management. 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.
People and relatives felt staff were kind and caring and knew them well. Staff arrived on time and people said staff stayed the correct amount of time. People said they felt their cultural needs such as food and language, were respected.
Staff told us they felt supported in their role and were able to discuss any concerns with the manager. There were regular staff meetings. There were various mechanisms for people, relatives and healthcare professionals to give feedback.
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 15 July 2022 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about information held in people’s homes, risk assessments and care plans, medicines management and managerial oversight of the service.
We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well led sections of this full report.
Enforcement
We have identified 4 breaches of regulation in relation to assessing people’s risks, staff recruitment, person centred care planning and good governance of the service.
We will request an action plan from the provider to explain how they will address the breaches found during 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.