Background to this inspection
Updated
11 June 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 6 May 2021 and ended on 12 May 2021. We visited the office location on 6 May 2021.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with three relatives of people using the service about their experience of the care provided. We spoke with nine members of staff including the service manager, deputy manager, senior support workers and support workers.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision, a variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We looked at training and supervision data. We also reviewed quality audit records.
Updated
11 June 2021
About the service
Elyon Healthcare is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to younger and older adults. At the time of our inspection 15 people were using the service, 3 of which received personal care.
CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
We gathered feedback from relatives of people using the service, this was positive. One relative told us, “They [staff] are great, they always listen to us and want to find out as much as they can about [person]” and “We have regular contact, we are involved in all reviews of [my relative’s] care.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not support this practice.
The service carried out regular audits to monitor the quality of the service. The provider had identified they did not have evidence of lasting power of attorneys. Although initially they had contacted relatives to obtain the records, the provider had failed to follow this up. This meant that decisions were being made without evidence of the legal authority required to do so.
People were protected from abuse. There were systems and processes in place to protect people from avoidable harm. Staff understood their responsibilities on how to identify and report concerns and felt confident that the management team would action these appropriately.
Medicines were managed safely. Staff received training in the administration of medicines during their induction and undertook annual refresher training.
Staff were recruited safely. The service organised staff allocation so that a small group of familiar staff supported each person.
People's needs were assessed before they started using the service to ensure these could be met. Relatives told us they had been fully involved in the assessment and care plan process.
Staff had completed induction training prior to delivering services to people and they had regular refresher courses to maintain their skills and knowledge. Staff received training and support in relation to infection prevention and control
People were supported to maintain or improve their health. They had access to external health care professionals when needed.
The management team gathered feedback about the quality of the service through telephone calls, surveys and visits to people using the service and their relatives.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People received person-centred support to achieve positive outcomes. Staff had received training about people’s right and choices, and this was promoted in their practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 22 May 2019) with breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
Why we inspected
We received concerns in relation to the safety and wellbeing of people using the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led.
We found no evidence during this inspection that people were at risk of harm from this concern.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We have found evidence that the provider needs to make improvements. Please see the effective and well-led sections of this full report.
The overall rating for the service remains requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elyon Healthcare on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.