Background to this inspection
Updated
4 February 2022
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service did not have a manager registered with the Care Quality Commission as required by law. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. There was a care manager in post who told us they were in the process of applying for registration.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We spoke with one person who used the service and two relatives about their experience of the care provided. We spoke with four members of staff including the manager, and care workers
We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation. Inspection activity was carried out on 6, 7 and 11 January.
Updated
4 February 2022
About the service
Esmero Care Services Limited is a community-based care provider that provides personal care to people living in their own homes. At the time of inspection five people were receiving a service and all were in receipt of the regulated activity of personal care.
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
Unsafe moving and handling techniques were being used by staff to support people to mobilise. Risk assessments did not always contain clear guidance to staff.
The manager of the service had not completed any moving and handling training themselves and therefore, had not identified where staff were not following safe practices.
The provider’s systems and processes for the management and oversight of the service were not consistently effective and had not identified the concerns we found during the inspection. There was no registered manager in post as required by law.
Staff had received training in safeguarding and knew how to keep people safe. The provider had recruitment processes in place to ensure suitable staff were employed. Medication was administered safely. Staff followed safe infection control practices.
Staff had received induction training to give them the skills and knowledge to support people safely however we found some staff were not following correct moving and handling techniques after completing their training.
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 kind and caring staff who respected their privacy and dignity and supported their independence.
Care plans in place were personalised and showed the support people needed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 20/08/2020 and this is the first inspection.
Why we inspected
This was a planned inspection of a newly registered service.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.
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 will continue to monitor the service.
We have identified breaches in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.