- Homecare service
Efficiency Health and Homecare Services - Malmesbury
Assessment report published 10 June 2025
Contents
Ratings
Our view of the service
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.
People's experience of this service
People and relatives shared mixed feedback about the service. Whilst people and relatives thought people were safe overall there were some concerns about safe care and support. People told us they had regular visits from staff. However, some people’s visits were consistently late, and some people said they did not receive a telephone call to let them know staff were held up. One person said, “they often don’t come on time” while another said “there are issues with the timing of care”.
People said staff were caring. Comments about the staff included, “I get on well with the carers” and “I have used the service for a year now and I am happy, I can raise concerns”. People shared mixed feedback about communication. Some people told us communication was good, however, some people said they had difficulties communicating with the office. One person raised a concern about staff stating “my carer is up at 5am to start [work] and does not finish until 12am”.
People were positive about the care co-ordinator and said “they are responsive”. We looked at the complaints log and found that complaints had not been followed up in a timely way despite the policy stating that complaints would be followed up within 2 working days.