We carried out a review of the data available to us about P & E Care Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about P & E Care Limited, you can give feedback on this service.
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 told us they felt safe. Risks to people had been assessed and staff knew how to manage identified risks safely. There were sufficient staff employed by the service to meet people’s needs. People told us staff visited them at the times they expected and that they had not had any missed visits. The provider followed safe recruitment practices. People received appropriate support, where required, to take their medicines. Staff worked in ways that minimised the risk of infection.
People were protected from the risk of abuse because staff knew the types of abuse that could occur and the action to take if they suspected abuse had occurred. Staff went through an induction when they started working for the service and were supported in their roles through training and regular supervision. People were supported to maintain a balanced diet and had access to a range of healthcare services when required.
Staff sought people’s consent when offering them support. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The provider worked with other agencies to ensure people received effective, high quality care. Staff were aware to report any incidents and accidents which occurred. The provider reviewed incident and accident records for any learning and to reduce the risk of repeat occurrence.
People’s needs were assessed before they started using the service. They were involved in the development of their care plans, which reflected their individual needs and preferences. Staff treated people with care and consideration. People were involved in making decisions about the support they received. Staff treated people with dignity and respected their privacy.
People knew how to complain and expressed confidence that any issues they raised would be addressed by the provider. Staff supported people to take part in activities, to reduce the risk of social isolation. The registered manager demonstrated a good understanding of the responsibilities of their role. Staff spoke positively about the support they received from the provider and registered manager. They told us they worked well as a team and were well supported by the registered manager.
The provider had systems in place for monitoring the quality and safety of the service. People’s feedback was sought through regular conversations with the registered manager and an annual survey. The outcome of the most recent survey showed that people experienced positive outcomes from the support they received.
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 14 August 2018) and there was a breach of one regulation. 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 the regulations.
Why we inspected
This was a planned inspection based on the previous rating.
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.
The service had 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.
At our last inspection we found improvement was required to ensure staff had sufficient time for travel between calls, and to the management of people’s medicines because one person’s MAR did not accurately reflect the medicines staff were supporting them with and this had not been identified by the provider’s medicines audits. We also found that improvement was required in regard to record keeping at the service.
At this inspection we found the provider had acted to address the issues we identified at our last inspection. However, we also identified a breach of regulations because risks to people had not always been comprehensively assessed and there was not always detailed guidance in place for staff on how they should manage identified risk safely. We also found that whilst people received safe support with their medicines, further improvement was required because there was not always guidance in place for staff on the support people needed to take medicines that had been prescribed to be taken ‘as required’. Additionally, improvement was required to the provider’s systems for monitoring the quality and safety of the service because audits of people’s care records had not identified any concerns with people’s risk assessments.
There were sufficient staff deployed by the service to meet people’s needs and people told us they were satisfied with the timings of the visits they received. The provider followed safe recruitment practices when employing new staff. People were protected from the risk of abuse because staff received safeguarding training and were aware of the action to take if they suspected abuse had occurred. Staff were also aware of the provider’s whistle blowing policy and told us they would use it if they had concerns. The provider monitored incidents and accidents and acted to reduce the risk of repeat occurrence. Staff were aware of the action to take to reduce the risk of the spread of infection and people told us staff followed safe infection control practices.
People’s needs were assessed in order to ensure the service’s suitability. Staff sought people’s consent when offering them support. People were supported 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. People were supported to maintain a balanced diet where this was part of their assessed needs. Staff received an induction when they started working for the service and were supported in their roles through regular training, supervision and an annual appraisal of their performance.
People were able to access a range of healthcare services with the support of staff if needed. The provider worked with other agencies to ensure people received effective care. Staff treated people kindly and with dignity. They respected people’s privacy and involved them in decisions about the support they received. People received care which reflected their individual needs and preferences. Staff encouraged people to maintain their independence where possible. The registered manager told us they would look to provide appropriate support to people at the end of their lives, although none of the people using the service required end of life care at the time of our inspection.
The provider had a complaints policy and procedure in place and people confirmed they knew how to complain. The registered manager maintained a complaints log detailing the action taken to address any complaints and people confirmed any issues they had raised had been dealt with to their satisfaction. People’s views on the service were sought through the use of surveys and quality assurance visits and the provider acted to address any issues identified as a result of their feedback. All of the people we spoke with told us they were happy with the service they received.
The provider ensured the rating of the service was on display at the service and the registered manager submitted notifications to CQC, in line with regulatory requirements. People, their relatives and staff spoke positively about the registered manager and the management of the service. The provider held regular staff meetings to update staff on service developments. The provider worked openly with other agencies, including a commissioning local authority in order to provider a good quality service.
The service did not have a registered manager in post since the last registered manager deregistered in August 2016. 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. The provider appointed a new manager in September 2016. The new manager had made an application to become the registered manager for the service. The manager demonstrated good knowledge of their responsibilities, people’s needs and the needs of the staffing. The manager was supported by the director.
People and their relatives told us they felt safe with staff. The service had clear procedures to recognise and respond to abuse. All staff completed safeguarding training. The manager completed risk assessments for people who used the service which provided sufficient guidance for staff to minimise identified risks. The service had a system to manage accidents and incidents to reduce reoccurrence.
The service had enough staff to support people. The service provided an induction and training to staff, and staff were supported through regular supervision to help them undertake their role.
However, we found the rostering of people’s home visits was not managed well in all cases and this required improvement. The service carried out satisfactory background checks of staff before they started working. Staff supported people so they took their medicines safely. However, one person’s medicines administration record (MAR) and medicines care plans did not include information about their prescribed medicine, the dose required and the frequency of administration.
People’s consent was sought before care was provided. The manager was aware of the requirements of the Mental Capacity Act 2005 (MCA). At the time of inspection they told us they were not supporting any people who did not have the capacity to make decisions for themselves.
Staff supported people with food preparation. People’s relatives coordinated health care appointments to meet people’s needs, and staff were available to support people to access health care appointments if needed.
People told us they were consulted about their care and support needs. Staff supported people in a way which was caring, respectful, and protected their privacy and dignity. Staff developed people’s care plans that were tailored to meet their individual needs. Care plans were reviewed regularly and were up to date.
The service had a clear policy and procedure for managing complaints. People knew how to complain and would do so if necessary. Staff felt supported. The manager held regular staff meetings, where staff shared learning and good practice so they understood what was expected of them at all levels.
People and their relatives commented positively about staff and the service. Nevertheless, improvement was required around record keeping and identifying issues at audits. The service carried out unannounced spot checks at people’s homes and telephone monitoring to get the feedback on quality of care.