Excel Living Limited

Updated 8 November 2019

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

The inspection of Excel Living Limited was carried out by one Adult Social Care Inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing. At the time of the inspection, the provider was supporting five people to live in their own homes.

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. The registered manager was also one of the directors of the service.

Notice of inspection

This inspection was announced.

What we did before the inspection

Before the inspection we reviewed information we had received about the service since the last inspection. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events, which the service is required to send us by law. 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 this information to plan our inspection.

During the inspection

During the inspection we visited two people who received care and support from the service. We spent a period of time observing the interactions between them and the staff team. We did this to assess what the quality of care was for those people who could not describe this for themselves. We spoke with three members of staff, as well as the registered manager and director.

We looked at two people's care records, together with other records relating to their care and the running of the service. This included three staff employment records, policies and procedures, complaints, audits and quality assurance reports.

Updated 8 November 2019

About the service

Excel Living Limited is a domiciliary care agency providing personal care to people living in their own homes. There were five people using the service at the time of the inspection who had a learning disability or mental health illness. The service supported a further four people that were not receiving 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.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and or autism to live meaningful lives that include control, choice and independence.

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

People received a high level of individualised care and were supported by staff that were kind, caring and compassionate. Staff valued people as individuals and had formed supportive relationships with people. Staff knew how people preferred their care and support to be provided. People were placed at the centre of the service and were consulted on every level. Respect for privacy and dignity was at the heart of culture and values of the service.

People continued to receive exceptional, person-centred care from the outset. Their wishes were understood and close relationships between people, staff and families had developed. Family members told us the care their relatives received was exceptional and had far exceeded their expectations. There was a high quality, bespoke and flexible approach towards people’s changing needs and preferences. The service was responsive to people’s needs and was able to accommodate sudden changes in people’s needs. People were empowered to achieve their goals. Activities were promoted by staff to prevent social isolation.

People showed they felt safe with staff who were highly motivated, knowledgeable and skilled to provide each person with the support they needed. Staff were fully aware of policies and procedures to keep people as safe as possible and rigorously followed risk assessment guidelines to ensure nobody was put at risk. Staff supported people 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. The provider followed their recruitment procedure which ensured all staff were safely employed. Induction training was thorough and the training for staff was kept up to date which meant they could provide effective care. People received medicines from staff that had been trained and their competency assessed.

Staff had received training to meet the needs of people using the service. They had also received regular supervision and an appraisal of their work performance. People's health needs were identified, and they were supported to maintain regular appointments and screening. People were supported to eat and drink. Specialists were involved when required for people who were nutritionally at risk.

The staff team were passionate at promoting people’s independence and ensuring people’s homes and facilities where appropriate to meet people’s needs. The staff team had taken steps to support people to make the appropriate adaptations to their homes. This included air conditioning being installed and a garden area adapted which had improved people’s wellbeing.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People benefitted from a service that was well led by a committed and skilled management team who led by example. The management promoted a positive culture that was open and transparent. They used effective checks and audits of care to provide high quality, person-centred care. There was an ongoing plan of development for the service. The staff team were well trained and supported, and communication was good. Staff were motivated and reflected pride in their work. They talked about people in a way which demonstrated they wanted to support them as much as possible and provide the best standards of care.

Why we inspected

This was a planned inspection based on the previous

Rating at last inspection The last rating for this service was good (published 09 March 2017).

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Excel Living Limited on our website at www.cqc.org.uk