We carried out a review of the data available to us about Essex on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Essex, you can give feedback on this service.
About the service
Essex (Realcare Health services) is a domiciliary care agency that provides personal care and treatment for disease, disorder and injury to older adults, children and younger adults in their own homes. Not everyone who used the service 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. They were providing personal care to five people at the time of the inspection.
People’s experience of using this service and what we found
At the previous inspection we found breaches to managing medicines safely and quality assurance. At this inspection we found the service had improved in these areas and were no longer in breach.
The service was able to work with people who were at the end of their life. We have made a recommendation about recording end of life wishes as this was not systematically completed as best practice guidance recommends.
There were safeguarding systems and processes in place that kept people safe. Risks to people were monitored and mitigated against. There were robust recruitment processes in place and sufficient staff to support people. Staff understood the need for infection prevention. The service sought to learn lessons when there were incidents and accidents.
People’s needs were assessed before they used the service to determine if the service could support people or not. Staff were supported through induction, training, and supervision. People were supported appropriately with their nutrition and hydration. Staff worked with other agencies, including health professionals, to provide effective 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; the policies and systems in the service supported this practice.
People were well treated and policies and procedures at the service supported equality and human rights. People expressed their views and had input into their care. People's privacy and dignity were respected. People were encouraged to be independent.
People's care plans were personalised and provided instructions, so staff could provide them with care in a way they preferred. People’s communication needs were met. People were supported to partake in activities. People and relatives knew how to make complaints, though there had been no complaints since our last inspection.
People thought highly of the service management. Staff knew their roles and responsibilities. People and staff were able to feedback about the service and be involved with decision making about care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last and only previous rating for this service was requires improvement (published 28 December 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
Why we inspected
This was a planned inspection based on the previous rating.
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.
This service is a domiciliary care agency. It provides personal care to people living in their own houses. It is registered to provide a service to people who misuse drugs and alcohol, children, older adults, younger adults, people with mental health issues, people living with dementia and people with physical disabilities. A small number of people were using the service at the time of our inspection.
The service did not have a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found two breaches of regulations during this inspection. This was because medicines were not managed in a safe way and the service lacked quality assurance methods and monitoring systems that might improve the service for people or make the service better or more efficient. The provider did not record meetings with people or relatives as best practice would dictate. The provider did not seek feedback from people or relatives. You can see what action we have asked the provider to take at the end of the full version of this report.
We have also made one recommendation about the supervision of staff.
There were appropriate safeguarding procedures in place and people told us they felt safe using the service. Risk assessments provided information about how to support people and mitigated against risk and harm. There were sufficient staff working at the service to meet people's needs and recruitment procedures aimed at keeping people safe. Staff understood infection control issues and used protective clothing when necessary.
People’s needs were assessed before the service worked with them. This meant the service determined whether they could provide the right care for people. Staff received induction training before starting work at the service and had access to regular training that helped them support people’s needs. The service operated within the principles of the Mental Capacity Act 2005 and staff understood the need to seek consent from people. The service supported people to access health care professionals when required.
People were supported by the same staff so they could build good relationships. People were treated in a compassionate manner by staff and where possible were supported to maintain their independence. People’s privacy and dignity was respected.
Care plans were detailed and personalised to meet people’s individual needs and had clear instructions for staff to provide the right care. The service had a complaints procedure in place and people knew how to make a complaint. The service had the ability to be able to provide end of life care.
People and staff spoke positively about the nominated individual who was managing the service. The nominated individual had links in to peer providers. People, relatives and staff knew what to expect from the service as this was set out in the service user guide and the service’s mission statement.