Eleanor Nursing & Social Care Ltd - Greenwich Branch

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

We found the provider to be in breach of the legal regulation in relation to safe and effective staffing. Staff were not effectively deployed and people experienced inconsistencies with the quality of care they received.

This service scored 62 (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 had a proactive and positive culture of safety. Systems were in place to respond to and monitor incidents if and when they occurred. Records showed incidents were investigated and measures put in place to prevent further reoccurrence. Lessons were learnt to identify and embed good practice via staff training and changes to systems to embed good practice where needed.

The registered manager understood their responsibilities with regards to duty of candour and notifying the CQC and relevant healthcare professionals of any significant events at the service.

Care records included prompts for staff in relation to maintaining people’s safety and reporting and recording of incidents. Staff were aware of actions to take in such instances. A staff member told us, “I would call 999 and call the office and let them know what is happening, I will wait and monitor the client and document everything. I would also call 111 for advice depending on the incident.”

The provider worked with people and healthcare partners to establish and maintain systems of care. They made sure there was continuity of care when people used and moved between different services. A person told us, “I’ve had good care since I came out of hospital. I was late leaving the hospital and the ambulance crew phoned [Eleanor] and let them know. They were very good and said, ‘don’t worry they [staff] will be there’ and they came at 6pm, that was good.”

There was a collaborative approach which was organised with staff and relevant healthcare professionals during people’s care journey. A healthcare professional told us, “Eleanor always keep us up to date and informed us of any appointments and any referrals they have made. They do not wait to make the required referrals in the best interest of people, which evidences they are in tune with people and their needs and take action promptly.”

The provider worked with people and healthcare partners to understand what being safe meant. People and relatives told us they felt safe using the service. A person told us, “Yes, I do [feel safe]. Because they [staff] are both very nice and they make me feel confident…they help me and they talk to me.” Another person told us, “I feel safe, they [staff] come in, tell me their name, show me their badge and talk to me.” A relative also told us, “Very safe. [Person] has the same person every time, she makes sure [person] is ok and gets on really well with them.”

Procedures were in place to help safeguard people from the risk of abuse and improper treatment. Safeguarding and whistleblowing policies were in place to report potential abuse. Staff had completed safeguarding training and were aware of the different types of abuse and reporting procedures to follow if they had any concerns. A staff member told us, “Safeguarding is to keep people safe and protect them where needed. To report concerns I would follow safeguarding procedures, contact the coordinator and manager and document it.”

Where there were concerns of abuse, the registered manager had notified and worked with relevant healthcare professionals, including the local authority safeguarding team and CQC to ensure any concerns were acted upon to keep people safe. A healthcare professional told us, “Eleanor has been very proactive in bringing any concerns they have. They raised concerns appropriately and we were able to move a person where they were free from further abuse and had a better quality of life. Eleanor were part of the professionals who considered it would be in the person's best interest. They genuinely advocated for this outcome.”

The provider worked with people to understand and manage risks. Risks to people were assessed and risk assessments were in place which provided information on how to maintain people’s safety in accordance with people’s specific needs.

Risk assessments covered areas such as mobility, health and safety, nutrition and hydration, medicines and finances and included measures to help minimise risks to people. This helped people to take responsible risks as part of their daily lifestyle with the minimum necessary restrictions and staff provided this in a supportive way. A person told us, “I have a walking frame. I would not be able to walk on my own and they [staff] are all behind me.” A relative told us, “Very safe, they [staff] know what they are doing.”

Processes were in place to ensure any restrictions on people were risk assessed to ensure they were necessary and safe such as the use of bed rails and people understood their use and purpose to maintain their safety.

The provider detected potential risks in the care environment. Processes were in place to ensure risks within people’s home environment were assessed and monitored. Assessments of people’s homes were carried out covering areas such as limited space, home security, gas and electrical appliances to ensure people were supported in a safe, clean and clutter free environment.

Staff were aware of their roles to ensure care environments were safe and equipment used to deliver care was safe and suitable for the intended purpose. They told us, “When I go in, I will make sure the lights are on, no clutter, no trip hazards like wires or spillages. Always observing the dangers and checking for hazards all the time” and “I check for loose wires and make sure there is plenty of space to move and turn and people have their zimmer frame or walking sticks with them.”

The provider did not work well to make sure staff were effectively deployed to provide safe care that met people’s needs. The provider did not make sure people always received their calls at the time planned for them and that staff stayed the full length of the calls. The service used an electronic call monitoring system (ECM) to record staff attendance times and support provided to people during each visit. However, during this assessment, we found calls were not always managed well and staff were not deployed effectively to meet people’s needs. A person told us, “A carer comes whatever time of day. It stresses me out. I can wait till 12 o’clock, that’s half a day gone. Sometimes, they’re 10.45 calls, sometimes 11.15, I asked for 8 or 9 o’clock.” Another person told us, “I mentioned the different times [to Eleanor]. It was agreed my care would be 9.30, but calls are still happening at 10.45 or 11.15 since.” A third person told us, “My problem with the carers they get allocated a time with me, they get a call from the office and they leave without doing tasks they are supposed to do…..they leave the care early and log out. They don’t always give me a choice.”

Relatives also told us, “Some come late…at weekends it is at 9am. One [carer] came at 7am on Saturday. Some leave early… You get fed up. Yesterday, someone came at 10 o’clock.” Another relative told us, “The time is the essential thing, during the week it’s not a problem at weekends it’s a bit more haphazard.”

We reviewed ECM monitoring records from January to March 2026 which also reflected people not receiving their calls as planned. For example, for one person, their evening scheduled call time was 19.30pm, however staff had logged in at 18.15pm, which was 1 hour and 15 mins early. For another person, their morning scheduled call time was 11.20am, however staff had logged in at 12.33pm which was 1 hour 13 minutes late.

The times detailed on ECM records and daily notes completed by staff also did not always correlate with the duration times of planned calls. For example, for a 30 minute call, for one person the call duration logged by staff was 17 minutes and for another person, the call duration logged by staff was 15 minutes. A person told us, “It depends on the carers, they don’t wash me thoroughly, they skimp. Not everyone, I do ask them and they resent me asking, some of them. I’m paying for 45 minutes and they are only here for 30 minutes.”

We raised this with the registered manager who told us they had strengthened their monitoring of time keeping and rota adherence by staff which was being monitored monthly. The registered manager told us this was reviewed by planned times versus actual time attended to track staff performance and implement corrective actions where needed including improving communication with the coordination teams to improve the management of call visits.

Notwithstanding the above we received positive feedback from some people. A person told us, “I am pleased with the ones that come to me. Early in the morning and early evening, that’s what I wanted….they help me to wash and dress. Even the young ones that come weekends, they are lovely. I have never had to wait.” A relative told us, “It’s all good about their timekeeping. If they’re late, they’d let us know.”

The provider followed safe recruitment practices and had ensured appropriate pre-employment checks were completed satisfactorily before staff were employed. Records showed staff had completed training in areas such as safeguarding, infection control, moving and handling and health and safety. Staff received supervision and appraisal to monitor and review staff performance. The competency of staff was also assessed through spot checks and any areas of improvement were identified and addressed by the provider.

The provider assessed and managed the risk of infection. Procedures were in place to ensure people were protected from the risk of infection. The service had an infection control policy in place. Staff had received infection control training and had access to personal protective equipment [PPE] when needed. A staff member told us, “Yes. They [Eleanor] give plenty. Any time you can come and collect extra PPE.”

People and relatives told us staff always wore PPE when supporting them with personal care. A person told us, “[Staff] wear gloves, aprons, masks. They change their gloves all the time.” A relative told us, “Yes, [staff] usually wear gloves and aprons and they change gloves after personal care.”

The provider made sure that medicines and treatments were safe. Medicines administration records (MARs) showed people received their medicines as prescribed. A person told us, “She [staff] does it very well. She takes it out of a package…makes sure I have something to drink, milk or water. She always does, puts it in my hand and says ‘there you go.’”

Medicines audits were carried out to ensure any shortfalls were identified and followed up. Records showed staff had completed medicines training and their competency was checked to ensure they were competent and administered medicines safely.