Elmes Homecare

Elmes Homecare is a domiciliary care agency. It provides care and support to adults and older people living in their own homes within the community. Not everyone using the service receives a regulated activity. CQC only inspects the service being received by people provided with personal care; that is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection there were 23 people using the service that were in receipt of the regulated activity of personal care.

People’s experience of using this service and what we found

People told us they felt safe. People were safeguarded against the risk of abuse and harm. Risks to people's physical and mental health needs were assessed, monitored and reviewed to ensure their safety and well-being. People were supported to manage their medicines safely. Appropriate recruitment checks took place before staff started work and there were enough staff available to meet people’s care needs. Staff followed government guidance in relation to infection prevention and control. Staff had received training on Covid 19 and the use of personal protective equipment (PPE).

Assessments of people’s care needs were carried out before they started using the service. Staff had received training and support relevant to people’s needs. Where required people received support to maintain a balanced diet. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

There were systems in place to regularly assess and monitor the quality of service that people received. Staff told us they received good support from the registered manager. The provider sought people’s feedback through satisfaction surveys and reviews to help improve the service. The registered manager and staff worked with health and social care professionals to plan and deliver an effective service.

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 rating for this service was Good report published (13 February 2020).

Why we inspected

We received concerns in relation to safeguarding incidents and the care and welfare of people using the service. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-led only. 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.

The overall rating for the service remains ‘Good’. This is based on the findings at this inspection. We found no evidence during this inspection that people were at risk of harm from these concerns.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elmes Homecare on our website at www.cqc.org.uk.

Elmes Homecare is a domiciliary care agency. It provides care and support to adults and older people living within 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. At the time of our inspection there were 11 people using the service in receipt of personal care.

The last rating for this service was requires improvement (published 24 October 2018) and there were multiple 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.

People’s experience of using this service and what we found

The quality and safety of the service had improved since our last inspection. The registered manager ensured the required actions were taken and improvements were made in line with their improvement plan.

People and their relatives spoke positively about staff and told us they were happy with the service they received.

People told us they felt safe and had not experienced any abuse, neglect or discrimination. People were protected from the risk of avoidable harm because risks were identified, assessed and managed safely by staff. People’s medicines were safely managed. People were protected from the risk of infections. Lessons were learnt from accidents and incidents. There were sufficient staff available to support people’s needs and appropriate robust recruitment practices were in place.

Staff were supported through induction, training and supervision to ensure they had the knowledge and skills to support people safely. People were supported where this was part of their plan of care to meet their nutrition and hydration needs. People had access to healthcare services and staff worked in partnership with health and social care professionals. 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 supported by staff that were kind and caring. People were involved in making decisions about their care and support needs and had choice and control over their lives. People’s privacy and dignity was respected, and their independence promoted.

People told us they knew how to make a complaint. People’s communication needs were assessed and met and people were provided with information in a format that met their needs. There were systems in place to assess and monitor the quality and safety of the service and to continuously learn and drive improvements. The service worked in partnership with key organisations to plan and deliver an effective service.

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 10 January 2019).

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.

Elmes Homecare is a domiciliary care agency. It provides personal care and support to people in their own homes. Not everyone using the service may receive the regulated activity; personal care. 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 service had a registered manager in post. 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.

At this inspection we found breaches of legal requirements because staff recruitment procedures were not robust to ensure staff were suitable and able to provide care and support safely and the provider failed to ensure there were comprehensive, robust systems in place to monitor the quality and safety of the service provided to people. You can see the action we have told the provider to take at the back of the full version of the report. We have also made a recommendation to the provider about the correct completion of mental capacity assessments in line with the codes of practice and principles of the Mental Capacity Act 2005.

Assessments were conducted to identify, assess and manage risks to people’s health and well-being. However, assessments were not always detailed and did not always provide guidance for staff on how to support people to manage identified risks and this required improvement. People were supported where required to safely manage and administer their medicines but improvement was required to ensure medicines records were monitored and audited on a regular basis. There were system’s in place for investigating and learning from incidents and accidents. However, no monitoring systems were in place to identify any themes or trends and to prevent reoccurrence and this required improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Care staff were aware to seek consent from people when offering them support and demonstrated a good understanding of the Mental Capacity Act 2005. However Mental capacity assessments were not completed in line with the codes of practice and principles of the Mental Capacity Act 2005. People told us they felt staff were skilled and understood how best to support them. Staff completed an induction before they started working with people. This was in line with the Care Certificate. Staff told us they received training appropriate to meet the needs of the people they supported and supervision on a regular basis. However, practical office based training for staff was not delivered by appropriately trained staff and this required improvement.

There were policies and procedures in place to safeguard people from possible harm or abuse and staff we spoke with understood the types of abuse that could occur, the signs they would look for and how to report any concerns. There were arrangements in place to deal with emergencies and infection control. There were consistent levels of staff who provided regular care to people. Assessments of people’s care and support needs were carried out before they started using the service. People told us staff supported them to meet their nutrition and hydration needs where this was part of their plan of care. People received support to manage their healthcare needs.

People and their relatives spoke positively about the care they received from staff. People and their relatives told us they were consulted and involved in planning and reviewing their care and support needs and were provided with information that met their needs to help support decision making. People and their relatives told us that staff treated them with respect, supported their independence and maintained their privacy and dignity.

People received personalised care that met their needs. Care plans were developed in collaboration with people and their relatives where appropriate and from information gathered about them to reflect their individual needs and preferences. Care plans considered the support people may require with regard to any protected characteristics they had under the Equality Act 2010. The deputy manager told us that no one currently using the service required support with end of life care. However, they advised that if someone required this support they would liaise with the person, their relatives and health and social care professionals to ensure they could provide the correct level of support they may need. People told us they were aware of the provider’s complaints procedure and would raise any concerns or complaints if they needed to.

People, their relatives and staff spoke positively about the registered and deputy manager. Staff told us that they attended regular team meetings and had the opportunity to discuss areas which effected their work and the service. There were systems and processes in place to gather feedback from staff, relatives and people using the service. The service worked with external organisations including health and social care professionals to ensure people’s needs were met and were active with supporting the local community.