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Inspection Summary


Overall summary & rating

Good

Updated 20 October 2018

The inspection started on 13 August 2018 and ended on 4 September 2018.The inspection was given two days notice of our inspection.

At our last inspection the provider was found to be in breach of Regulation 17 Good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of: Is the service Safe? Is the service Effective? and Is the service Well-led? to at least good.

At this inspection we found that sufficient improvement had been made to show that the provider was no longer in breach of regulation.

Eldercare is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, some of whom may be living with dementia. At the time of inspection 86 older people used the service. One of the directors, who was also the registered manager, was present throughout the inspection.

There was a manager in post who had registered with CQC. 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.’

Since the last inspection, quality assurance processes had been introduced to monitor and improve the service. These had checks been conducted on a regular basis but had not always been effective in identifying when documentation had not been returned to the office for monitoring. We have made a recommendation about this.

Safe recruitment processes continued to be followed although references did not always record dates to evidence when they had been received. The registered manager took action to correct this during the inspection.

Risk assessments were in place where required. There was a safeguarding policy and procedure in place and staff had been provided with safeguarding training. The management team were fully aware of the process to follow if any concerns were raised.

There were enough staff available to meet people’s needs and attend planned care visits. People were supported by a consistent team of staff and pre-admission assessments had been completed to ensure the service could meet people’s needs before a package of care was accepted.

Since the last inspection staff had been provided with additional training to ensure they had the skills and knowledge to carry out their roles. A training plan was in place to ensure all training was delivered and refreshed within required timescales. Supervisions had begun to take place although this was not yet in line with the frequency outlined in the provider’s supervision policy.

Improvements had been made to the management of medicines. Medicines had been administered and recorded appropriately. An auditing system was now in place to highlight and respond to any shortfalls.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People had signed their care plans to consent to the support they were receiving.

People were encouraged to remain as independent as possible and their choices were respected by staff. Support with meals was provided where required.

Care was delivered in accordance with people’s wishes and needs and care plans contained person-centred information. Relatives told us they were kept informed if any changes occurred.

People knew how to make a complaint and were confident any issues would be promptly addressed. The provider had a complaints policy and procedure in place and this was included in the service user guide.

The registered manager requested feedback from people who used the service and relatives. The results of these surveys had been analysed and action taken when shortfalls were identified. People, relatives and staff spoke positively about the management team and their approach.

Regular staff and management meetings took place to ensure all employees were kept up to date with changes and developments within the service.

Inspection areas

Safe

Good

Updated 20 October 2018

The service was safe.

Risk assessments were in place to help minimise risks to people.

Staff understood and followed the safeguarding procedures in place.

Safe recruitment processes had been followed and people were supported by a consistent team of staff.

Effective

Good

Updated 20 October 2018

The service was effective.

Supervisions had started taking place. Appraisals had been completed and staff told us they felt supported within their role.

People received support to maintain a balanced diet, where assistance was required with this.

The principles of the Mental Capacity Act 2005 had been followed.

Caring

Good

Updated 20 October 2018

The service was caring.

People told us staff were kind, caring and professional.

Staff were able to describe how they ensured people’s privacy and dignity was respected.

Care records evidenced people’s independence was promoted.

Responsive

Good

Updated 20 October 2018

The service was responsive.

Care plans contained person-centred information that focussed on what was important to the person.

Reviews of people’s care and support needs took place on a regular basis to ensure their needs were being met.

A complaints policy and procedure was in place. People knew how to raise a complaint.

Well-led

Requires improvement

Updated 20 October 2018

The service was not always well-led.

Quality assurance processes were now in place to monitor and improve the service, although action taken as a result was not clearly recorded.

Staff and management meetings took place.

Feedback from people had been requested by the provider and action was taken to address any areas of concern raised.