Archived: Emergency Personnel Homecare Ltd

Updated 11 December 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 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.

The inspection took place on 8 and 13 November 2018 and was announced. The provider was given 72 hours’ notice because we needed to ensure somebody would be available to assist us with the inspection.

The inspection was carried out by one inspector. Inspection site visit activity started on 8 November and ended on 23 November 2018. We visited the office location on 8 and 13 November 2018 to see the registered manager, office staff and to review care records and policies and procedures. During and after the site visit we made calls to people who used the service, their relatives and members of staff.

Before the inspection we reviewed the information the CQC held about the service. This included notifications of significant incidents reported to the CQC and the previous inspection report. In addition to this we reviewed the Provider Information Return (PIR) that was submitted by the provider at the time of their previous inspection. 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 spoke with six relatives as people were too young or unable to communicate with us over the telephone. We also spoke with nine staff members. This included the registered manager, two directors, two bookings consultants, the human resources administrator, a registered nurse and two care workers. We looked at three people’s care plans, three staff recruitment files, four staff training files, staff supervision records and records related to the management of the service.

Following the inspection we spoke with one health and social care professional who worked with people using the service for their views and feedback.

Updated 11 December 2018

This comprehensive inspection took place on 8 and 13 November 2018 and was announced. At the previous comprehensive inspection on 4 April 2018 we were unable to rate the service. At the time of the inspection, only one person had been receiving personal care for a limited period of time. This meant that although we were able to carry out an inspection we did not have enough information about the experiences of a sufficient number of people using the service over a period of time to give a rating to each of the five questions and an overall rating for the service.

This service is a domiciliary care agency. It provides nursing and personal care to people living in their own homes in the community. It provides a service to older adults, younger disabled adults and children. At the time of the inspection they were supporting 11 people across the London Boroughs of Wandsworth, Enfield, Croydon, Bromley, Camden, Barnet, Southwark, Lewisham and also Essex. Nine of these people were young children. Not everyone using Emergency Personnel Homecare Ltd 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 at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Risks to people were identified during an initial assessment. Detailed guidance was in place with information from health care professionals to enable staff to support people safely and meet their complex care needs. Risk assessments were updated when people’s needs changed and information was shared with staff that supported them.

People who required support with their medicines received them safely. Care records included information about people’s medicines and the level of support they needed. All staff had completed training in medicines within the last six months and was scheduled to be refreshed annually.

Relatives told us that they felt safe using the service and staff were confident that any concerns would be investigated and dealt with. All staff had received training in safeguarding adults and children from abuse and had a good understanding of how to identify and report any concerns.

People were supported to maintain their health and wellbeing through access to health and social care professionals, such as paediatricians, community nurses, social workers and respiratory consultants. The provider worked closely with them to ensure effective communication and any changes in health were reported and updated accordingly.

The provider understood the legal requirements of the Mental Capacity Act 2005 (MCA). Agreements were in place and recorded how people consented to their care and support.

Registered nurses and care workers received specialist training to support them in meeting people’s complex needs. Shadowing opportunities and staff competency assessments were completed before staff started work with people. Staff felt supported and were happy with the supervision they received and the content of the training available.

People’s nutritional needs were recorded in their care plans with detailed information about the level of support required. Nutritional risks were highlighted with further guidance available for people who needed extra support.

Relatives told us that staff were kind and compassionate and knew how to provide the care and support they required. People had regular nurses and care workers who had built up positive working relationships with them and their families. Staff respected people’s privacy and dignity and worked closely with relatives to help meet their needs.

Care was personalised to meet people’s individual needs and was reviewed regularly if there were any significant changes. The provider ensured people and their relatives contributed to their assessment and listened to how people wanted to be supported. People were provided with information on how to make a complaint and felt comfortable raising concerns if they needed to.

There were a range of checks and meetings in place to understand the experiences of people who used the service and monitor the quality of the service provided. Relatives and staff were regularly contacted by the management team to ensure people’s needs were met.

The service promoted an open and honest culture and staff spoke highly of the working environment and the support they received. Staff were confident they could raise issues or concerns at any time, knowing they would be listened to and acted upon immediately.

We will continue to monitor this service. When services are rated ‘Good’ we aim to return within 30 months.