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Evolving Care Limited

Overall: Requires improvement read more about inspection ratings

Eureka House, 196 Edleston Road, Crewe, CW2 7EP (01270) 448336

Provided and run by:
Evolving Care Limited

Important: We are carrying out a review of quality at Evolving Care Limited. We will publish a report when our review is complete. Find out more about our inspection reports.

Latest inspection summary

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Background to this inspection

Updated 21 August 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

This inspection was carried out by two inspectors.

Notice of inspection

We announced the inspection visit 24 hours before it took place. This was because we needed to information in advance of our visit due to the COVID-19 pandemic.

Inspection activity started on 20 May 2021 and ended on 2 July 2021. We visited the service on 20 May and 16 June 2021.

What we did before the inspection

We reviewed the information we received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with ten people who used the service and the representatives of a further four people who used the service about their experiences of the care provided. We also spoke with the manager, and nine members of staff including, a care coordinator, four care staff, the locality trainer, two administrative staff and the quality lead. We looked at the recruitment files for two staff employed since the last inspection. A variety of records relating to the management of the service were also reviewed. We also spoke with community based professionals including a specialist Parkinson’s nurses and a Practice Manager of the local Adult Safeguarding Provider Team

Due to the impact of the COVID-19 pandemic we limited the time we spent on site. Therefore, we requested records and documentation to be sent to us, reviewed these off site and continued dialogue with the manager by telephone.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Overall inspection

Requires improvement

Updated 21 August 2021

Evolving Care is a domiciliary care service providing personal care to 98 people at the time of the inspection. 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.

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

Risks presented to people and staff by the COVID-19 pandemic were not assessed or recorded and staff were not always being tested for COVID-19 in accordance with government guidelines.

Medicines records and governance arrangements did not always assure that medicines were managed safely.

Some people received consistent care and support from staff who knew them well and were familiar with their needs. Six out of fourteen people spoken with told us that they, or their relatives, had received inconsistent care with staff often arriving too early or too late.

An electronic call monitoring system was used to ensure that managers were able to respond when calls were late or missed but this was not being used effectively and the information produced was not always reliable.

The provider's quality systems were not sufficiently robust to identify the concerns we highlighted with lack of COVID-19 risk assessment, medicines and electronic call monitoring records. The provider was very responsive in taking actions to address the issues we found on inspection however we could not fully assess the impact of these actions until they were fully embedded.

Risks to people’s health and well-being other than those associated with the COVID-19 pandemic were clearly identified and care plans set out what support the person needed in the way they wanted their care to be provided.

People told us that they felt safe whilst receiving care and many were complimentary about the standard of care and services they had received.

The providers policies and procedures had been revised in the light of the COVID-19 pandemic and staff had received relevant training and had access to appropriate personal protective equipment (PPE) in accordance with government guidelines.

Rating at last inspection. The last rating for this service was good (published 31 August 2019).

Why we inspected

We received concerns about the reliability and safety of the service. As a result, we undertook a focused inspection to review the key questions of Safe and Well led only.

We reviewed the information we held about the service. No areas of concern were identified in other key questions. We therefore did not inspect them. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified a breach of regulations in relation to governance and record keeping at this inspection. Please see the action we have told the provider to take at the end of this report.

Prompt action was taken by the registered manager after the inspection to mitigate risk and improve the quality of care in response to the concerns we found during our inspection.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection program. If we receive any concerning information we may inspect sooner.