Ethical Homecare Solutions

Updated 28 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 6, 7 and 21 February 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 6 February and ended on 21 February. It included a visit to the location premises, speaking to people who used the service and staff on the telephone. We visited the office location on 6 February 2018 to see the registered manager and office staff; and to review care records and policies and procedures. The expert by experience spoke by telephone with four people and four relatives to gain their experiences of the service on 7 February 2018. Telephone calls to five staff members were made on 21 February 2018.

The inspection was carried by one adult social care 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. Our expert by experience had experience of caring for an older person.

The inspection was informed by feedback from questionnaires completed by a number of people using the service. The Care Quality Commission sent surveys to: four people and four people's relatives; we received a response from two people and one relative and 19 surveys were sent to community professionals and we received two responses.

Before the inspection, we reviewed the information we held about the service. This included notifications we had received. A notification is information about important events such as accidents or incidents, which the provider is required to send us by law. We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. The PIR was submitted within the required timescale.

The care records for three people who used the service were looked at. We also looked at other important documentation relating to people who used the service such as incident and accident records and medication administration records. We looked at how the service applied the Mental Capacity Act 2005 to ensure that when people were assessed as lacking capacity to make their own decisions, actions were taken in line with the current legislation.

A selection of documentation relating to the management and running of the service was looked at. This included four staff recruitment files, training records, staff rotas, minutes of meetings with staff, complaints and quality assurance audits.

Updated 28 March 2018

This was an announced comprehensive inspection carried out on 6, 7, and 21 February 2018.

At the last inspection in November 2016, we found people were not protected against the risks associated with medicines because the provider did not always have appropriate arrangements in place to manage medicines. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions, safe and well led to at least good. At this inspection we found the provider had made the required improvements.

Ethical Homecare Solutions provides a domiciliary care service to adults and older people with varying needs and disabilities living within the Leeds area. The office, based in the Chapeltown area of Leeds is staffed Monday to Friday during office hours. An out of hours phone service is also available. At the time of this inspection the service was providing the regulated activity of personal care to 31 people who lived in their own homes. The service is provided to younger adults, older people, people living with dementia, people who may have a learning disability or autistic spectrum disorder, mental health issues and physical disabilities. Not everyone using Ethical Homecare Solutions receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.

The feedback we received from people was very positive throughout. People who used the service spoke highly of all staff and services provided. One person told us, "The whole experience has been first class, I couldn't have wished for a better team of people to care for me."

People's medicines were managed safely. The safety of people who used the service was taken seriously and the registered manager and staff were aware of their responsibility to protect people's health and wellbeing. There were systems in place to ensure that risks to people's safety and wellbeing were identified and addressed and lessons were learnt to ensure problems or mistakes were not repeated.

The whole staff team were highly motivated and proud of the service. The registered manager told us, "We have recruited some really special people who share our values of being trustworthy and caring and who recognise that dignity, respect and integrity are at the heart of what we do."

People were encouraged to be as independent as possible by staff they trusted and felt safe with. They were supported to lead as good a quality of life as possible. The service supported people to access activities which were meaningful to them. People's wellbeing, privacy, dignity and independence were respected and encouraged.

People were never rushed and staff took the time to support them in the right way. People who used the service valued the relationships they had with staff and expressed satisfaction with the care they received. There was an effective complaints procedure in place and people told us they knew how to complain.

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. Staff had received training on the Mental Capacity Act 2005. They ensured people were asked for their consent before they carried out any care or support.

People were cared for by staff who were aware of their safeguarding responsibilities. Staff had received training in how to safeguard people from potential abuse and knew how to identify the risks associated with abuse. Staff were safely recruited, trained and supervised in their work. They enjoyed their jobs, felt included and listened to in the running of the service.

There were risk assessments in place and staff had a good understanding of the risks associated with the people they supported. Each person had risk assessments and a care plan in place. People and their families were involved in the planning of their care and these were regularly reviewed. When changes in care support were required, these were carried out in a timely way. Staff supported people to eat a nutritious diet with food and drinks of their choice.

The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of everyone who used or came into contact with the service. The service fostered good partnerships with other agencies and organisations. The provider was committed to continual improvement and governance was embedded in every part of the service.