Background to this inspection
Updated
12 January 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 07 December 2016 and was announced.
The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
The inspection was carried out by a single inspector and an expert-by-experience carried out telephone interviews with people using the service and their relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert for this inspection had experience of caring for a person who used domiciliary care services.
Prior to the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information sent to us in the PIR and notifications we had received from the provider. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about. We also contacted and obtained feedback from one healthcare and two social care professionals.
During the inspection we looked at records, including seven people’s care plans, four staff records, medicine administration records and records relating to the management of the service. We spoke with the registered manager, the area manager, a care coordinator, a field supervisor and two care workers.
After the inspection we spoke by telephone with eight people who used the service and six relatives.
Updated
12 January 2017
We undertook an announced inspection of Excelcare (Homecare Division) Limited on 07 December 2016. We gave the provider 48 hours’ notice because the location was a domiciliary care service and we wanted to make sure that someone would be available to assist with the inspection.
The service was registered with the Care Quality Commission on 01 March 2016 and had not been inspected before.
Excelcare (Homecare Division) LTD (Ealing office) is a domiciliary care agency providing personal care and support to people who live in their own homes. At the time of our inspection there were 61 people receiving a service. The agency provided care and support to people with a range of different needs, including older people, some of whom were living with long term conditions or dementia and children and younger adults who were living with learning or physical disabilities. Excelcare Homecare Division Limited has been providing homecare since 2000. Their first branch opened in Tower Hamlets, followed by the Ealing Branch which opened in 2008 and their latest branch in Milton Keynes was opened in 2014.
There was a registered manager in post at the time of our 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 told us that care workers were sometimes late particularly at weekends.
All but two people we spoke with and their relatives said that they were happy with the level of care they were receiving from the service. Those who had been unhappy told us that there had been a marked improvement in the last few weeks and were happy to continue receiving care from the agency.
The risks to people's wellbeing and safety had been assessed, and there were detailed plans in place for all the risks identified.
There were procedures for safeguarding adults and the staff were aware of these. The staff knew how to respond to any medical emergencies or significant changes in a person's wellbeing.
Feedback from people and relatives was positive. Everyone said they had formed a good rapport and trusted the care workers.
People's needs were assessed by the provider prior to receiving a service and support plans were developed from the assessments. People had taken part in the planning of their care and received regular visits from the senior staff.
The registered manager and staff were aware of their responsibilities in line with the requirements of the Mental Capacity Act (MCA) 2005 and had received training in this. People had consented to their care and support and nobody was being deprived of their liberty unlawfully at the time of our inspection.
There were systems in place to ensure that people received their medicines safely and the senior staff carried out regular audits.
Recruitment checks were in place to obtain information about new staff before they supported people unsupervised.
People's health and nutritional needs had been assessed, recorded and were being monitored.
Care workers received the training and support they needed to care for people.
There was a complaints procedure in place which the provider followed. People felt confident that if they raised a complaint, they would be listened to and their concerns addressed.
There were systems in place to monitor and assess the quality and effectiveness of the service, and the provider ensured that areas for improvement were identified and addressed.
People and relatives told us that the staff were approachable and supportive. There encouraged an open and transparent culture within the service. People were supported to raise concerns and make suggestions about where improvements could be made.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related the person-centred care. You can see what action we told the provider to take at the back of the full version of this report.