Background to this inspection
Updated
18 April 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. 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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector and an Expert 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
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
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 registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since their registration. We sought feedback from the local authority. 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. We used all this information to plan our inspection.
During the inspection
We spoke via telephone with 2 people using the service and 5 relatives, who had given us permission to contact them. We also spoke with 5 staff including the director, the registered manager and care staff. The registered manager is also the nominated individual. The nominated individual is responsible for supervising the management of the service on the behalf of the provider.
We reviewed a range of records, including 3 people’s care records, 2 staff recruitment files, records relating to medicines, training and supervision, accident and incidents and safeguarding logs. Also, a variety of records relating to management of the service, including audits and policies and procedures were reviewed.
Updated
18 April 2023
About the service
Excel24/7 Healthcare Ltd is a domiciliary care agency providing personal care to people living 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 8 people using the service.
People’s experience of using this service and what we found
Risks assessments for specific health conditions were not always in place to guide staff should a person’s condition deteriorate. We recommended the provider completes individual risk assessments for people with specific health conditions. Accidents and incidents were not always recorded. This was rectified during the inspection process. All required checks had been completed prior to staff starting employment and there was a robust induction programme. Systems and processes were in place to safeguard people from abuse and staff had good knowledge of the steps to take to protect people. People that use the service felt safe. Medicines were well managed and risks to people were identified. Risks associated with COVID-19, and other infectious diseases, were identified and managed.
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’s needs were assessed prior to them starting to use the service. Detailed care records were in place to guide staff on the care and support people needed. Staff had the training and support they needed to carry out their roles effectively. Staff worked alongside other agencies to provide joined up, effective care.
People were treated well, and their individuality was respected; They told us staff were kind, polite and caring. Care records indicated how best to communicate with people and how staff could support people to express their wishes. People and their relatives spoke highly of this service and the registered manager conducted regular spot checks to ensure staff were treating people with dignity.
People received personalised care that took account of their needs, wishes and preferences. The provider was following the Accessible Information Standard. People were involved in the care planning process and relatives felt staff were responsive to changes. There was a system for logging and responding to complaints.
The registered manager understood their duty of candour, however there was one incident that should have been reported that had been overlooked. This was rectified during the inspection process. There was a range of oversight, quality, and auditing. People spoke positively about the service they received and described the registered manager as nice, helpful, and organised. Staff also spoke highly of the management team and felt able to approach them should they have any concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
This service was registered with us on 15 June 2022 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service, the length of time since registration and to provide a rating for the service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.