We carried out a review of the data available to us about Ethos Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ethos Care, you can give feedback on this service.
Ethos Care is a domiciliary care agency providing personal care and support to people in their own houses and flats. The service provides support to people in the Christchurch area of Dorset. At the time of our inspection there were 39 people receiving personal care and support.
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.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Culture
Governance systems were not always operating effectively, they had not identified some documentation was not in place for staff recruitment and actions from audits were not always documented as carried out. The service actively sought feedback on the service it provides and made individual changes for people. However, this was not consistently recorded and therefore feedback was not always used to shape the service. We have made a recommendation to the service about strengthening the systems, and they have been responsive to rectify the shortfalls. The registered manager and manager understood their statutory responsibilities and had made notifications to CQC as required by law. Staff felt appreciated by the management team, there were various ways the service showed thanks to their staff. There was a small staff team and they told us they felt involved.
Ethos Care was linked with the providers other service, they offered each other support. The service worked well with external health and social care professionals, and we received positive feedback on their working relationship. The Ethos Care management team were approachable, visible and supportive.
Right Support
There were enough staff to meet the needs of the service. Recruitment processes were in place to ensure staff had the necessary checks before starting work with the service. However, we found some gaps in the documentation, the manager acted immediately to obtain the missing information. People were protected from avoidable harm by a staff team who knew how to raise safeguarding concerns both within the service and outside. Staff told us they were confident their concerns would be acted upon by the manager.
Risks to people had been identified, assessed and actions taken to reduce them, this included environmental risks. Staff knew people well and risk assessments covered all aspects of their daily care and support. Staff had access to the electronic system which explained safe working practices. People told us they were happy with the service they received from Ethos Care. 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. Staff told us they promoted independence for people, one person told us, “They [staff] enable me to have a life.” People told us they knew who would be visiting them to provide care and were kept informed if staff were going to be late.
Right Care
People received their medicines as prescribed. Medicines management within the service was monitored by an electronic system. Staff had received training including regular assessment of their competency. An electronic care planning and medicines system supported safety, as changes to medicine regimes were made without delay. The system sent alerts to staff in the service office and they acted on any changes.
People were protected from the risk of avoidable infection. Staff had received training in infection prevention and control. There were plentiful supplies of personal protective equipment (PPE) for staff. The policy and guidance were in line with government and best practice guidance.
Accidents and incidents were recorded, analysed for themes and trends. Leadership was visible and staff knew their roles and responsibilities.
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 (published 12 December 2018).
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 remained as good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
At this inspection we found the service remained good.
The home had a registered manager. 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.
People continued to be supported by staff who had been trained to recognise and report any concerns of abuse or poor practice. People had their risks understood and staff knew the actions needed to minimise risks of avoidable harm whilst respecting people’s freedoms and choices. Medicines had been administered safely by staff who were trained and had their competencies regularly checked. Infection control systems and practices were effective in reducing preventable infections.
Staff had been recruited safely including checks with the disclosure and barring service to ensure they were suitable to work with vulnerable adults. Staffing levels enabled a flexible approach to meeting people’s care needs. Staff induction, on-going training and support enabled them to carry out their roles effectively.
Assessments had been completed initially which captured peoples care needs and choices and included any necessary equipment such as telephone alarm systems. This information had been used to create person centred care plans that were person centred and reflected people’s individual life style choices and communication skills. People had their eating and drinking needs understood and when needed additional support had been requested of GP’s and speech and language therapists.
The care team worked effectively with other professionals such as district nurses and occupational therapists enabling positive outcomes for people. When people had changes in their health they had been supported to access healthcare. People had opportunities to be involved in end of life planning and files contained information about people’s decisions about resuscitation.
People are 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 was provided in a kind and compassionate way which recognised and respected people’s right to privacy, dignity and independence. People felt involved in decisions about their care and felt able to raise a concern knowing it would be listened to and actioned.
The management of the home promoted an open and transparent culture which encouraged and enabled people, their families and the staff team to be involved and engaged with service delivery and development. Staff understood their roles and responsibilities and spoke positively about the management of the service.
Quality assurance processes were effective in ensuring regulations were met and sustained. When areas were highlighted as requiring improvement actions had been taken appropriately and had improved outcomes for people.
Information sharing with other professionals and agencies enabled the service to keep up to date with best practice and new innovations.
Further information is in the detailed findings below.
The service had a registered manager. 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.
Assessments had been completed to identify any potential risks people were living with. One person had risks associated with their weight and nutrition due to their physical and mental health. Reviews of the risk had been completed but were not robust enough. Although a care plan was in place it did not contain information about the actions staff needed to take to minimise any risk to the person of weight loss and poor nutrition. The care co-ordinator told us they would carry out an immediate review of the risk and add more detail to the care and support plan.
Risk assessments had been completed for people who needed support with moving and handling and management of their day to day money. The actions put in place minimised any associated risk to the person. Staff demonstrated a good understanding of any assessed risk and the actions they needed to take to minimise it.
People’s Medicine Administration Records (MAR) were maintained and medicines were stored and administered safely. However, care staff were not recording on the MAR chart when they had applied prescribed creams. We discussed this with the deputy care co-ordinator who told us they would have the creams added to the MAR sheets immediately.
People told us they felt safe. Staff had completed safeguarding training and knew how to recognise signs of abuse and the action they would need to take if they suspected abuse.
There were enough staff to support people. Staff had been recruited safely. Procedures were in place to manage any unsafe practice.
Staff received an induction and on-going training that enabled them to effectively carry out their roles. They received regular supervision and an annual appraisal which provided an opportunity for personal development.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We found the service was working within the principles of the MCA. Care staff understood their role in ensuring people consented to their care and support.
Care workers had a good understanding of people’s food and drink likes, dislikes and allergies.
People had good access to healthcare which included GP’s, district nurses and occupational therapists.
People told us the service was caring. Staff had a good knowledge of the people they were supporting. We observed positive friendly relationships between people and care workers. Conversations were relaxed but professional. People were supported to maintain their independence. People and their families felt involved in decisions about care. People told us their dignity was respected. Staff had a good understanding of how to respect a person’s right to confidentiality.
People had their care needs assessed and individual care plans had been written that described the actions staff needed to take to meet them. Staff demonstrated a good knowledge of people and how they liked to be supported. People had been supported to maintain links with neighbours, friends and shops in their local community. Staff responded to changing care and support needs of people.
People and their families knew how to make a complaint and felt any issues would be listened to and acted upon. Records showed us that a complaint had been investigated appropriately and the person had been happy with the outcome.
People, their families and staff all told us the service was well led and that communication with the service was good.
Staff had a good understanding of their roles and responsibilities and felt supported by senior staff and colleagues.
Audits were being carried out monthly. Completed audits had captured any areas where action was needed. A quality assurance survey was sent to people, their families, staff and other stakeholders annually. Areas identified that required improvement had been completed and sustained.