Enlightenment Care Services Ltd

Enlightenment Care Services Ltd is a domiciliary care agency providing personal care and support to people 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. At the time of our inspection there were 130 adults who received packages of support which included personal care.

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

Systems were in place to help safeguard people from abuse. Risk assessments were in place which set out the risks people faced and included information about how to mitigate those risks. There were enough staff to meet people's needs and robust staff recruitment procedures were in place. Steps had been taken to help prevent the spread of infections. Systems were in place for investigating accidents and incidents. Medicines were managed in a safe way.

Staff usually arrived within a window of time to people's homes and stayed for the correct length of time. Positive feedback was received from people about staff and the care they received. When people required support with preparing meals and drinks, this was provided.

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.

Quality assurance and monitoring systems were in place to help drive improvements at the service. There was an open and positive culture at the service, which meant people, relatives and staff could express their views. Where required, staff worked with people, relatives and health and social care professionals to maintain people's overall health and wellbeing.

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 6 March 2023). 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.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has improved to good. 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 Enlightenment Care Services on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Enlightenment Care Services Ltd is a domiciliary care agency providing personal care and support to people 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. At the time of our inspection there were 100 adults who received packages of support which included personal care.

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

Systems to assess, monitor and improve the quality of the service were not always effective. This included oversight of visit times and duration, people's care records, daily notes and medicines. Quality assurance checks took place in some of these areas but did not identify the issues we found during this inspection.

The provider was in the process of transitioning to a new electronic care planning system. Most care plans and risk assessments were incomplete or not up to date. Staff did not have access to detailed and accurate care records about people's current care needs and risks to their care, in order to ensure safe care was provided.

Concerns found at the last inspection about lack of detail in assessing and documenting people's capacity to make their own decision had not been rectified. No meaningful mental capacity assessments had taken place which placed people at risk of having decisions made which were restrictive or not in their best interests.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Processes to report accidents and incidents had not been established in the new care planning system. There was heightened risk of incidents and accidents not being properly recorded and reported due to processes not being in place. There was no effective process in place to learn lessons when things went wrong.

Improvements were needed to care planning processes when people were discharged from hospital. This was to ensure people and their representatives were involved in their care planning and gave their consent to care commencing.

People were supported with medicines administration when this was required. We found some gaps in recording of medicines administration, including a lack of body maps to show were creams should be applied. We did not find any harm had been caused because of this.

Staff had not received training in all key areas of care provision to help ensure they had the skills and knowledge to fulfill their roles. We did not find any negative impact upon people’s care due to this.

People and relatives told us people were cared for safely. Staff had received training in adult safeguarding. Recruitment checks took place prior to new staff commencing work, although not all application forms contained full employment and education histories.

Staff usually arrived within a window of time to people's homes, and stayed for the correct length of time. Positive feedback was received from people about staff and the care they received.

When people required support with preparing meals and drinks, this was provided.

Staff worked with health and social care professionals involved in people's care and treatment.

The majority of staff who provided feedback during this inspection were very positive about working for Enlightenment Care Services. They felt supported in their roles by the management team.

The registered manager and management team were supportive of the inspection process and committed to making the required improvements. They were also working with the local authority to achieve this.

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 12 August 2022). 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 the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We have identified breaches in relation to people’s safe care and treatment, people’s consent to care, and governance arrangements at this inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained 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 Enlightenment Care Services on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Enlightenment Care Services Ltd is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection there were 52 people using the service.

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.

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

Some risks had not been fully assessed or documented in risk assessments.

Medicine administration records were not always accurate due to an electronic system not yet fully working the way the provider wanted it to.

Call timings were not always recorded accurately, due to the electronic system not working.

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 always support this practice. Mental capacity assessments were not always in place and did not always contain sufficient detail.

There were enough staff working at the service who were recruited using safe recruitment procedures.

Staff followed infection control procedures and wore personal protective equipment (PPE).

Staff were provided with sufficient induction training, and ongoing training to ensure their knowledge was up to date.

People felt well cared for by staff who knew them well.

Care plans were personalised, and reflected people’s likes, dislikes, and preferences.

A complaints policy and procedure was in place and people knew how to use it.

People felt the service was well run, and felt engaged with. Opportunities to feedback on the quality of the service were provided.

Staff felt well supported by management and told us that communication was good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for the service at the previous premises was good published on 27 March 2018.

Why we inspected

This was a routine inspection based on the amount of time passed since our last inspection, and the provider had changed address.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe effective and well led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

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

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.