Elgar Care Ltd

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People and relatives felt the care and support provided was safe and they could speak up if they had any concerns. One person told us, “I would contact the office if I needed, but every carer as soon as they come in, are respectful and considerate for what I need in that particular call.” A relative said, “I’d contact [nominated individual] but haven’t had to. There are no concerns and I’m a bit outspoken and would say if there was anything at all.” Another relative said, [Person’s name] is pretty black and white, and would tell me definitely if there was anything they weren’t happy about.” Another relative told us, “We’ve never had any concerns since [person’s name] started receiving a service.”

Systems were in place to record, manage and respond to accidents, incidents and events. Any outcomes or learning following events were shared with staff and relevant partners.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.Staff worked with people, their relatives and health professionals to ensure there was continuity of care, including reassessments and updating support plans after hospital admissions or period of ill or declining health. We saw feedback from a family member thanking all staff for the care and support they provided to their family member which said, “The transition to home would not have gone so well without you all.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe with staff. One person said, “I’m very safe. Every carer that arrives is respectful and considerate of my needs for the time they come here, and I feel very safe and secure.” A relative told us, “[Person’s name] feels safe and I feel safe as I’m the second carer for all the manual handling bits, and I feel secure that they know what they’re doing as we’re working together and working the same way.” Staff had received safeguarding training and were aware of their responsibilities to report any concerns. One staff member said, “I would quickly contact my manager. I know I am not alone and [registered manager] is always there and very helpful.” Another staff member said, “I would report to the office immediately and discuss with the manager who would raise safeguarding if needed.” A further member of staff told us, “I would report any worries or concerns to the office.” Safeguarding audits and safeguarding focused audits were carried out. We could see actions had been taken following these, including, where appropriate, staff were scheduled to complete safeguarding training. A safeguarding policy was in place which detailed the types of abuse and how to escalate concerns if staff suspected or saw any abuse to ensure people were protected.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. For example, 1 person who was living with multiple sclerosis shared their lived experience with the staff team. They were able to provide valuable insight into the challenges and impact of the condition on their daily life which not only enhanced staff understanding and promoted person centred care but also had a positive impact on the person’s wellbeing. The person shared, “Being able to share their knowledge and experiences gave them a sense of purpose, increased their confidence, and positively contributed to their mental health and self-worth.” The person expressed pride in being able to help others learn and felt valued for the contribution he made to improving care for others.

Systems were in place to assess risks when a person began using the service. This included all safety aspects of the person’s health, safety and wellbeing where they required support from staff. Reviews were completed following any changes to people’s needs and on a routine basis.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Risks associated with people’s home environments had been discussed and considered during initial assessment. This included potential hazards or risks around fire, utilities such as boiler and electrics and slips, trips and falls hazards.

The provider worked proactively with the Fire and Rescue Service to help keep people safe in their own homes. Where staff identified potential fire risks, or where people may be particularly vulnerable due to age, disability, reduced mobility or cognitive impairment, the provider made referrals for free Home Fire Safety Checks with the person's consent. Checks included tailored fire safety advice, smoke alarm checks and, where appropriate, additional equipment or support to reduce the risk of fire. This collaborative working meant people remained safe and independent within their own homes while reducing the likelihood of avoidable incidents.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider had systems in place to monitor call times. We analysed care call records for the previous 2 months. The data we looked at demonstrated some anomalies with gaps in call log in and log out times and duration. However, we discussed this with the registered manager who provided justifiable reasons for this. This assured us there was no impact on people receiving their planned care. People and relatives also confirmed this. No one raised any significant concerns with us in relation to the punctuality or duration of their calls. One person said, “Oh yes, yes, they’re on time. Sometimes a little bit late, but that can’t be helped. And they spend the (right amount of) time here.” A relative explained how both their parents were receiving support from Elgar Care Ltd and said, “They (staff) are always on time. If they’re even one or two minutes late, I get a call from the office to say they might be stuck in traffic or something else. Staff always stay with [family members] right through till the end of the call.” Another relative told us, “Oh yes, staff are on time only sometimes late with traffic issues or last-minute jiggle. But they usually quite good with the times and they stay (the time stipulated).” Staff confirmed they had sufficient times for visits and to complete tasks. One staff member said, “If not, that means the client’s circumstances have changed. Then the office is informed and they act on it if time needs to be extended.” Another staff member said, “There has been times in the past when calls have overrun due to client being unwell and my rota has been adjusted to fit this, but this is usually only in emergencies if client is unwell.”

Staff confirmed they had received the appropriate training to be able to support people effectively and safely. This included training in areas such as basic life support, catheter care, the Mental Capacity Act (MCA), moving and handling, learning disability and autism and the Care Certificate. The Care Certificate is an agreed set of standards that defines the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. It is made up of the 15 minimum standards that should form part of a robust induction programme. Staff also shared they are offered additional or extra training if needed. For example, 1 staff member told us how the provider had brought in a specialist nurse in motor neurone disease and nurse specialist in multiple sclerosis in to help staff’s understanding to enable them to support people living with these conditions more effectively.

Regular team meetings and supervisions were held with staff. One staff member said, “We are given options of days to attend (staff meetings). Also asked for input towards the agenda. Feedback also sent out following meetings. Also able to speak openly about anything.”

The provider had improved their recruitment process. This included being more flexible with hours, specific recruitment for certain clients, and different patterns to suit the staff, evenings and weekends.Recruitment records evidenced staff had been recruited safely to ensure they were of good character to support people in the community. This included Disclosure and Barring Service (DBS) checks. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.People or relatives did not raise any concerns about infection prevention and control (IPC). People confirmed staff wore appropriate personal protective equipment (PPE) such as aprons and gloves. Staff had received infection prevention and control training and there were policies and procedures in place.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

For people who needed support with taking their medicines, systems and procedures were in place. This ensured this was done safely and people received their medicines as prescribed and on time. One person told us, “They (staff) give me my medication, and I know what it is and when to take it. They just hand it to me.” A relative said, “I do the tablets, but if there are any creams, then they (staff) do them. There’s never been a problem.” Another relative told us, “There are no concerns with any medication, no, as they’re very, very on the ball, and I’d say even more than me.” Staff were trained in the administration of medication and regularly had their competencies checked. Audits were regularly carried out. As part of these, checks were completed on whether electronic medication administration records (eMAR) were fully and accurately completed with allergies documented; ‘as and when’ PRN protocols were in place where required; topical medication guidance was available; medication errors were reviewed and actioned; staff medication competencies were in date; medication storage in the person’s home was appropriate; and spot checks were completed on staff for medication practice. Any areas identified as requiring improvement were addressed and actioned.