Archived: Eve Home Care

Updated 25 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection site visit activity started on 3 July and ended on 19 July 2018. We gave the service 48 hours’ notice of the inspection visit because it is small and we needed to be sure somebody would be in the office. The inspection included visits to the office location to see the managers and review care records and policies and procedures. We visited and telephoned people who used the service and their relatives. The inspection was completed by one inspector.

A Provider Information Return (PIR) is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. Our inspection commenced prior to the PIR submission closing date. We therefore ensured key information and any improvement plans were discussed during our inspection.

We reviewed information we had about the service including notifications. The provider is legally required to send us notifications with regards to any changes in the organisation or significant incidents and events. We also contacted the local authority commissioning group and the local Healthwatch, a consumer group who aim to share the views and experiences of people using health and social care services in England. This information was included within our planning of the inspection.

During the inspection, we spoke with two people supported by the service and three relatives. We reviewed documentation relating to three people which included including risk assessments, care plans and reviews. We considered information in relation to the running of the service including staff rotas, compliments and complaints and accidents and incidents. We spoke with three members of staff and both managers. We reviewed files for three members of staff in addition to an overview of staff’s training records.

Updated 25 September 2018

We inspected this service on 3 and 19 July 2018. This was our first inspection of Eve Home Care.

Eve Home Care is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to both younger and older adults and people living with dementia or physical disabilities.

At the time of our inspection, there were eight people who used the service. Not everyone using the service received support with a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

The two directors of Eve Home Care had both applied to become the registered managers and were actively managing the service at the time of our inspection. We have referred to them as ‘the managers’ throughout this report. A registered manager was in post when the service opened but left in March 2018. 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.

The managers had failed to ensure recruitment was safe and robust. Staff recruitment records did not always contain full employment histories and gaps in employment had not been explored. Verbal references were obtained but there was no written evidence of the information provided or documentation to show that interviews had taken place.

We found documentation relating to people’s medicines and potential risks to them were not always in place. However, people were supported by a consistent team of staff who were familiar with their needs and the support required. This reduced the potential risk for people.

New staff shadowed experienced members of staff before working alone. However, there was no agreed induction process to show new staff had been provided with important information about the service and people they supported and had the necessary skills and knowledge.

Staff had not always completed the necessary training to ensure they were sufficiently knowledgeable and skilled to provide people with effective care.

Effective systems and processes had not been implemented to monitor the quality and safety of the service, to maintain standards or drive improvements.

People told us they felt safe with staff. Staff understood what actions to take to safeguard people from potential risk of abuse. Accidents and incidents were recorded and staff knew what to do in an emergency situation.

The managers and staff understood the importance of the Mental Capacity Act 2005 (MCA). However, information was not robustly recorded or assessments completed where one person was deemed to lack capacity.

People told us staff sought their consent and people had signed consent forms in place wherever they were able.

Staff liaised with professionals and people’s families to ensure they received input around their health needs. People received support to eat and drink and their choice was promoted.

Staff told us they felt supported in their role. However, there were limited records to demonstrate the support provided to staff.

People told us staff were kind and caring and provided dignified and respectful support. People and their relatives felt comfortable in the presence of staff.

The managers understood when people may require independent advocacy support and provided people with information about how to source this.

People’s documentation was not always person-centred and did not fully describe how to support the person. However, staff had built a rapport with the people they cared for and were person-centred in the way they delivered care.

The managers maintained regular contact with people to ensure they had no concerns and they were flexible in changing care calls when needed. A complaints policy was in place and people who used the service felt confident to raise any issues.

Staff told us the managers were supportive and people who used the service held the managers in high regard. People’s feedback about the service had been sought and the responses received had been very positive.

We found three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014, namely Regulation 17 Good governance, Regulation 18 Staffing and Regulation 19 Fit and proper persons employed. You can see what action we told the provider to take at the back of the full version of this report.