Eleanor Nursing & Social Care Ltd - Greenwich Branch

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider assessed and reviewed people’s health, care, wellbeing and communication needs. Detailed assessments of people’s needs were carried out before they used the service to ensure their care needs could be met.

People and relatives were involved in the assessments to enable them to make an informed choice about their care. Expected outcomes for people’s care were identified and used to develop people’s care plans.

The provider planned people’s care with them, including what was important and mattered to them. People were supported to eat, and drink based on their individual preferences and needs. Where people required support with eating and drinking, this was recorded in their care records. A person told us, “They [staff] provide me with meals. You tell them what you want, and they get it for you. I get what I want. If you ask them, they make drinks. They leave a drink I can reach every time.”

Care records contained information on how to manage identified areas where people were at risk of poor nutrition or had swallowing difficulties. When speaking to staff they showed an awareness of people’s requirements with their food and drink. A staff member told us, “[Person] has to have small square bits of sandwich, it has to be cut up into easy to swallow manageable pieces. We make sure we are there with [person] when they are eating.” Another staff member told us, “[People] could have allergies and have cultural needs for food or drink or pureed diet. I have a client who is on pureed and smooth food only, they have speech and language [SALT] input who recommended that, so we make sure food is pureed completely and follow that advice.”

The provider did not always work well across teams to support people. Teams did not work well together to ensure people always received regular staff to support them with their care and support, therefore, people experienced inconsistencies with the quality of care they received. A person told us, “During the week, regular [carers], it’s not so good on the weekend. I keep telling them [Eleanor], they know. They [staff] do what they are supposed to do, but especially the first call, they take me for a shower, and you don’t like to have to be undressed in front of different people every day. I wish the morning carer could be the same.” Another person told us, “My regular staff is very good. The time she is off on a weekend has caused the most problems for me. During that time, I really have concerns. Sometimes they will send three different carers in a day… some will be late by the time they come….I have to take them to the kitchen, show them everything and some are not good ambassadors of Eleanor.” A third person told us, “Monday to Friday, I am extremely happy. On Saturdays and Sundays I get nervous. I am autistic. I’m sent different carers. I need to explain myself again and again.”

Relatives also shared similar concerns. A relative told us, “They [Eleanor] send them randomly, four different ones in a week, sometimes we have one who comes for a week. Different people every day is stressing [person]. They [Eleanor] are allowing different people. It is invading our privacy.” Another relative told us, “When the regular carer is not here, we get four different carers. When they’re on holiday, it is a problem. Every time, I have to explain; they’re different carers and they don’t know how to treat [person].

We raised this with the registered manager who told us they were working with the scheduling and coordination teams to ensure people were being informed of staff changes and to identify staff who have previously attended calls to people to promote consistency of care delivery.

Feedback from some people did indicate some improvement. For example, a person told us “I would say at the start it wasn’t great, multiple issues, lots of issues with carers. My [relative] has the App and contacted the council, but recently since some of the carers have changed and there is consistency with carers, and it’s getting better. Things have improved, but still a way to go.” A relative told us, “It’s adhered to now, the weekend ones were awful, they could be almost two hours late. I got in touch with the agency and said it can’t keep happening, it’s got better. I’m pleased the weekends have sorted themselves out.”

However, despite the actions taken, we found improvement was still needed. We will follow up the actions taken by the service to improve the consistency of staff at the next assessment.

Notwithstanding the above we received positive feedback from some people. A person told us, “I have regular carers. I get the same ones every day. Another person told us, “I have [regular carers], they are very good. I really rely on them. They make me feel at ease. I can’t make complaints about them at all.” A relative told us, “[Person] has the same [carer] unless they are away. If the carer is on holiday or sick they always let [person] know ..and [person] has another carer who they know."

The provider supported people to manage their health. People were supported to access healthcare services when required. A person told us, “If I want to go for my eye appointment, they [Eleanor] arrange for a time for a carer to accompany me.” A relative told us, “Recently [person]…complained of tummy pain. They [staff] told me I should get in touch with the NHS. I was struggling and they did it for me. An ambulance turned up in a few minutes, they were brilliant."

The provider worked in partnership with other healthcare professionals such as GPs, district nurses, occupational therapists and pharmacists to deliver effective and timely care. A healthcare professional told us, “We have a weekly catch up with Eleanor and local authority to review, discuss new referrals. The carers work well with people, are professional and treat them kindly. There have been no known complaints of the service either from people or our staff. The service will discuss with us any changes regarding health needs, and are very competent to make referrals to the wider multi-disciplinary teams (MDT) i.e. podiatry, physio. They work with care plans and update people’s clinical records every time they are seen. The Eleanor team have been a pleasure to work with, an asset to the service they provide.”

The provider routinely monitored people’s care and treatment. Care records detailed people’s outcomes they wished to achieve as part of their care journey and the provider worked with healthcare professionals. A healthcare professional told us, “They [staff] have always presented as caring, empathetic, understanding and professional. The carers have often come to me to update on a person following discussions with the team leader or to share suggestions on possible items which may assist a person.” Another healthcare professional told us, “"Eleanor Care tick all the boxes. I find the team friendly, helpful and always willing to go the extra mile to support people. I would go so far to say that if a relative or friend of mine required being supported in the community, I would highly recommend their services as I consider they would be well looked after".

The provider told people about their rights around consent and respected these when delivering care. Processes were in place to ensure the service acted in accordance with the provisions of the Mental Capacity Act (MCA) 2005 and peoples’ best interests were protected. Where people had the mental capacity to make decisions, records showed the service obtained their consent about their care and support. Where people lacked capacity, their mental capacity had been assessed and the best interest’s decision making process has been followed which included involving relatives and healthcare professionals when required.

Care records had been signed by people or where appropriate, their family representatives to indicate that they had consented to or been involved in their care plans. A person told us, “Yes, every time, they [staff] ask me if it’s alright for them to do it. I am very pleased with both of them.” A relative told us, “[Person] says they [staff] are very good and very kind. They ask [person] or say we are going to do this and that. We know we can rely on them.”

MCA policies were in place and staff had received MCA training. Staff told us they sought people’s consent before and offered choice when supporting them with their care and treatment. A staff member told us, “We must always get permission before providing the care because the person must understand what they agreeing to. We must communicate things throughout the care.”