Elect Care Consultants Ltd

About the service

Elect Care Consultants is a domiciliary care agency providing personal care and support to people living in their own homes. The service is registered to support older people with dementia and learning disabilities or autistic spectrum disorder and Sensory Impairment. At the time of this inspection 3 people were 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.

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

Right Support:

People were supported safely with their medicines. The service followed Infection prevention and control good practice guidance. People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people who used the service to be involved in maintaining their own health and wellbeing where possible. Staff communicated with the person in a way that met their needs.

Right Care:

Staff understood how to protect people from abuse. The service had appropriately skilled and trained staff to meet people's needs and keep them safe. People’s support was flexible and available when they required it. Care was delivered in a person-centred way and records reflected outcomes for people. People told us staff treated them with kindness and supported them to take part in their individually preferred activities. People were appropriately assessed before their support began. The service worked closely with external health care professionals to monitor the person's physical health needs when needed.

Right Culture:

The culture at the service was very positive. People, relatives and staff said they were listened to. The service was open to new ways of working and ongoing developments were introduced to promote independence and continuous improvement. Staff understood people’s support needs, which enabled the person to receive compassionate and empowering care that was tailored to their needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 27 August 2021). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

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 changed from requires improvement to good. This is based on the findings at this inspection

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Elect Care Consultants Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect

Elect Care Consultants is a domiciliary care service, providing personal care to people living in London.

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. On the day of the site visit, five people were receiving the regulated activity of personal care.

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

Most people and their relatives told us the service was safe.

At the last inspection we had concerns about staff recruitment procedures. At this inspection we could not be assured if improvements had been made.

We received mixed feedback about staff punctuality and staff deployment from people who used the service and their relatives.

We could not be assured staff were receiving regular supervision.

Before and during the inspection we had difficulty accessing the location and seeing records. The registered manager was not available and a person employed by the provider managed the service during this absence. We formally asked for documents after the inspection. We did not receive all the documents we requested. People’s and staff records were not accessible to authorised staff. This meant management cover arrangements were not safe.

We received mixed feedback about the management of the service. Systems for monitoring the quality and safety of the service were ineffective in ensuring records related to care and treatment were up to date. We were not assured the provider had effective systems and processes in place to ensure the safe running of the service.

Staff understood what action to take if they suspected somebody was being harmed or abused. Staff knew how to report accidents and incidents. People had risk assessments to keep them safe from the risks they may face. These were updated as needed and used to inform reviews of people’s care.

The provider had adequate medicines administration procedures in place.

The provider ensured there was infection control guidance in place. Staff confirmed they were provided with enough personal protective equipment such as masks and gloves.

People’s needs were met by staff who were appropriately trained. People’s dietary needs were met effectively.

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 requires improvement. (Report published on 16 January 2020) and there were multiple breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We carried out an announced comprehensive inspection of this service on 25 November 2019 and 3 December 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service is requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elect Care Consultants Ltd on our website at www.cqc.org.uk.

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 to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to staffing, staff recruitment, staff supervision and governance systems at this inspection.

Full information about CQC's regulatory response to the more serious concerns found during inspections is

added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Elect Care Consultants is a domiciliary care agency providing personal care to 21 people at the time of the inspection.

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

People’s medicine support needed to be clearer in their support plan. Staff were recording that medicine had been administered but this was not in accordance with guidance.

Staff completed most of their pre- employment checks. However, where a criminal records check was not in the recruitment file this was not provided after the inspection. We also noted in application forms staff had not provided previous education details.

Staff understood their safeguarding responsibilities and how to blow the whistle. People and their relatives told us they felt safe with staff. People felt punctuality of staff could improve for visits.

Risks to people were recorded and minimised. Staff were provided with equipment to prevent the risk of cross infection. There were systems in place to learn from incidents when they happened.

Staff told us they received training and support from the registered manager. People had their needs assessed before they received care from the service. People were offered choice and their consent sought before care was provided.

People were supported by kind and caring staff who did not discriminate against them. People’s privacy and dignity was respected and people were supported to be independent.

Support plans were personalised and contained people’s preferences. People knew how to make complaints to the service. The service had a strategy to support people at the end of their life.

Quality assurance systems were not thorough or consistent. Staff records were not readily available during or after the inspection.

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.

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 25 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe recruitment practices, staff support and supervision, good quality monitoring systems and management of records.

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.

Elect Care Consultants Limited provides personal care and support for people living in their own homes. At the time of the inspection there were six people using the service.

There was a registered manager in post who was present on the day of the inspection. 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 were protected from harm because staff had received training on safeguarding people from abuse. Assessments of potential risks were clear and included measures to reduce the likelihood of harm.

Care plans were tailored to meet people’s individual and diverse needs. They had a good emphasis on personalised care and reviews of their needs were carried out regularly.

People were supported by caring and kind staff. Communication with people was effective and staff listened when people made decisions about their care. Staff supported people with personal care respectfully and with discretion.

The provider had put systems in place to ensure the safe management of their medicines. Access to health services was sought when people’s health needs changed. People’s nutritional needs were met and their food preferences were documented in their records.

Pre-employment checks were carried out on staff before they were employed by the provider. People were supported by a sufficient number of staff that were well trained.

Appropriate capacity assessments had been carried out to ensure that decisions about how people’s needs were met were made in their best interests. Some staff had received training in the Mental Capacity Act but not all.

There was a programme of regular audits. The provider was proactive in ensuring they sought people’s feedback to improve the way care was delivered. People’s relatives spoke highly about the leadership and approachable nature of the registered manager.

People’s relatives were well informed about how to raise complaints and were confident they would

be resolved. Information was not provided in a format that was easy for people to read. The provider’s website did not display the previous Care Quality Commission (CQC) inspection report so people could chose if they wished to use the service.

We have made one recommendation about providing information in suitable formats to meet people’s individual needs.

There was a registered manager in post. 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.

We found that people were not protected from the risk of potential harm because staff could not identify different types of abuse and the related policy was not fit for purpose. Robust risk assessments were not in place to guide staff about how to manage risks to people. People were at risk of not living the way they chose because the registered manager had not embedded the principles of the Mental Capacity Act 2005 at the service.

Medicines were not well managed because there was not sufficient managerial oversight of staff practice. The provider could not be assured that staff were fit for work because criminal record checks and references were not always obtained. The provider was not meeting the requirements of the Mental Capacity Act 2005.

The service was not organised in a way that always promoted safe care through effective quality monitoring because audits were either not in place or were not fit for purpose.

There were enough staff to meet people’s needs and they developed caring relationships with people using the service. Staff used a range of communication methods to support people to express their views about their care. People and their relatives were involved in planning their care and care records included information about people’s likes and dislikes and promoting their independence

Staff supported people to eat and drink enough and to obtain treatment from health and social care professionals.

There was a positive and open culture at the service. Relatives felt confident that they could raise concerns and their complaints would be taken seriously.

We found six breaches of regulations relating to safeguarding service users from abuse, medicines, risk management, consent, fit and proper persons employed, and good governance. You can see what action we told the provider to take at the back of the full version of the report.

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