Background to this inspection
Updated
4 February 2023
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of one inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Eleanor Nursing & Social Care Ltd – Brent Office is a 'domiciliary care service' where people receive care and support in their own homes. Therefore, the CQC only regulates the care provided to people and not the premises they live in. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection. We visited the office location on 28 July 2022.
What we did before the inspection
Prior to the inspection we reviewed information and evidence we already held about this service, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the service. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also viewed the provider information return (PIR). 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.
During the inspection
We spoke with people’s relatives to help us understand the experience of people who could not talk with us. We spoke with nine relatives and 11 people who used the service. We spoke with the regional operations manager, executive assistant to the chief executive (CEO), branch manager, care coordinator and five care workers. We reviewed seven care records of people using the service, five personnel files of care workers, audits and other records about the management of the service.
Updated
4 February 2023
About the service
Eleanor Nursing & Social Care Ltd – Brent Office is a domiciliary care service which provides personal care and support to people in their own homes. At the time of the inspection there were 41 people using the service. 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.
The service did not always ensure there were sufficient numbers of suitable staff to support people to stay safe and meet their needs. People told us staff did not always arrive on time or stay for the duration of the visit. As a result, people did not always receive care that consistently met their needs.
There were no robust procedures to follow in an emergency to make sure sufficient and suitable staff were deployed to cover both the emergency and the routine work of the service. However, at the time of the inspection the service had made some improvements to their system for monitoring late and missed calls.
A new plan for responding to missed or late visits had been put in place. However, it was too early for the provider to be able to demonstrate that these processes were fully embedded and that these improvements could be sustained over time.
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 protected from the risk of harm and abuse. There were effective systems and processes in place to minimise risks. Care workers had been recruited safely and they knew how to identify and report concerns.
People had care plans that identified how their personal priorities and outcomes will be met. These showed people had been involved in the assessment process. Their care files contained meaningful information that identified their abilities and the support required.
Care workers were knowledgeable about people's needs. They had completed essential training and we saw from records they were up to date with it. They could describe to us how people liked to be supported.
People were protected from the risks associated with poor infection control because the service had processes in place to reduce the risk of infection and cross contamination.
There were systems in place which were regularly reviewed. A complaints procedure was in place, which people's relatives were aware of.
Quality assurance processes such as audits and spot checks were in place. We found the regional operations manager to be knowledgeable about issues and priorities relating to the quality and future of the service.
Rating at last inspection
This service was registered with us on 18/08/2020 and this is the first inspection.
Why we inspected
This was a planned inspection based on our inspection scheduling.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Enforcement and Recommendations
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 and will take further action if needed.
We have identified one breach in relation to staffing at this inspection. Please see the action we have told the provider to take at the end of this report.
We have made two recommendations, one about person centred care and the other about continuous improvements.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.