Efficiency Health and Homecare Services - Malmesbury

Date of Assessment: 10 October 2025. The service is a care at home service providing support to 12 adults of all ages and people living with dementia. This assessment was completed due to warning notices being issued by the Care Quality Commission (CQC) at the assessment completed in January 2025. During that assessment the service was found to be in breach of regulations in relation to safe care and treatment, staffing and governance.

During this assessment we looked for evidence that improvements had been made against the areas highlighted in the warning notices issued. We focused on the safe and well led areas of the service.

We found that improvements had not been made since our last assessment. We reviewed 5 staff files, spoke with 4 staff, 5 people and reviewed 5 people’s care records during this assessment.

During the first assessment we found medicines were not being managed safely. People’s care plans did not contain enough details for staff to know how to provide safe care. People’s risks were not being managed safely, and people did not always have risk management plans in place. Not all care plans contained accurate information. Some staff had not received all the training they needed to support people safely. Governance systems were not established and operating effectively to identify the shortfalls found during the assessment.

During this assessment, we found not enough improvement had been made. Quality checks being completed were not identifying the improvement needed for all areas of this service. The provider did not have a clear or robust action plan to enable them to take action to address the shortfalls we raised.

However, staff told us they enjoyed working for the provider and felt supported.

We found the 3 breaches of regulations remained: staffing, safe care and treatment and good governance. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and or appeals have been concluded.

Date of Assessment: 20th January to 23 January 2025. The service is a care at home service providing support to adults of all ages and people living with dementia. This is the first assessment for this service since it registered with the Care Quality Commission (CQC) on 5 January 2024. We inspected due to receiving concerns about how the service was run.

Medicines were not being managed safely. People’s care plans did not contain enough details for staff to know how to provide safe care. People’s risks were not being managed safely and people did not always have risk management plans in place. Not all care plans contained accurate and some had conflicting information. Some staff had not received all the training they needed to support people safely. Some staff had been recruited in line with legislation. Governance systems were not established and operating effectively to identify the shortfalls found during this assessment. Quality checks being completed were not identifying the improvement needed for all areas of this service. The provider had failed to notify CQC of events they were required to do by law. Accidents and incidents were not safely managed to record all actions taken and lessons learned were not identified nor shared with staff. The provider had not followed some of their policies. We reviewed 7 staff files and no files contained a written copy of a contract. Staff had not had regular supervisions. Not all complaints received were recorded.

However, staff told us they felt well supported by the provider and they all enjoyed their work. The provider carried out spot checks to monitor how staff were working in people’s homes.

We found 3 breaches of regulations: staffing, safe care and treatment and good governance. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and or appeals have been concluded. We have asked the provider for an action plan in response to the concerns found at this assessment.