Eleanor Nursing & Social Care Ltd - Lewisham Office

Eleanor Nursing & Social Care Ltd – Lewisham Office is a domiciliary care agency. It provides personal care for people living in their own homes. It provides a service to older adults and younger disabled adults. At the time of the inspection 340 people were using the service.

Not everyone who used the service received personal care. The Care Quality commission inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we consider any wider social care provided.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

People’s experience of using the service

The provider had not carried out checks in relation to care workers ongoing right to reside or work in the UK, or their conduct in previous health and social care employment.

People said they felt safe with the care workers who supported them. One person said, “We feel that the service is safe.”

The provider had a range of quality assurance audits and checks to monitor how care was being provided. Staff worked well with other health and social care professionals to ensure people’s health needs were being met. Carers received an induction and were introduced to people before they begun to deliver care.

Medicines were managed safely; risk assessments were in place to guide carers on how to care for people safely. There were systems in place for reporting of incidents. Preventative measures and lessons learned were suitably documented.

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 the last inspection

The last rating for the service was Good (inspection report published 15 March 2022)

Why we inspected

The inspection was prompted by a review of the information we held about this service.

Enforcement

We found 1 breach of regulation in relation to fit and proper persons employed. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

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

Medicines were not always been managed safely but there were improvements since the last inspection. The provider’s audits were not always identifying errors in people’s medicine administration records (MARS). We made a recommendation to the provider to ensure there were effective processes in place for medicines management.

Care workers had completed in-house training on how to administer medicines safely and appropriately with refresher courses every year which included a competency assessment.

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 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. We did however make a recommendation to the provider to ensure there were effective processes in place for medicines management.

Why we inspected

We undertook this targeted inspection to check whether the provider was still in breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on breaches or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service. If we receive any concerning information we may inspect sooner.

Eleanor Nursing & Social Care Ltd - Lewisham Office is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection the service was supporting 465 people.

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 medicines were not always administered or managed correctly. The provider was not always following their policy to safeguard people from financial abuse. Quality assurance processes were at times ineffective. The provider had safe robust recruitment procedures in place to safely recruit staff. Staff worked effectively within the providers infection control policy.

Staff completed training and received support to ensure they had the appropriate skills to meet people's care needs in a safe and effective manner. People were assessed before staff started providing care and support. People’s nutritional needs were being met. 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. Care plans recorded people’s needs and preferences. Risk assessments were in place to guide staff to provide safe care and support.

The provider had a range of quality assurance audits and checks to monitor how care was being provided. People receiving care, relatives and staff told us they felt the service was well run. The provider was committed to continuously learn and improve their practice. The service worked with a range of healthcare professionals and within the local community.

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 28 February 2019)

Why we inspected

This was a planned inspection based on the previous rating. We made a decision to undertake a focused inspection looking at the key questions safe, effective and well-led.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eleanor Nursing & Social Care Ltd - Lewisham Office 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. We will continue to discharge our regulatory enforcement functions required 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 safe care and treatment. Please see the action we have told the provider to take at the end of this report.

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.

This service is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection they were supporting 420 people. Not everyone using Eleanor Nursing & Social Care Ltd - Lewisham Office receives a 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 at the service. 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 given appropriate support with their physical healthcare needs, but care records did not contain enough information about people’s mental health histories where there had been issues in the past.

Risk assessments identified risks to people’s care and contained clear guidelines to care staff about how they were required to mitigate these. However, care records did not contain enough information for care staff where risks had been identified in relation to their nutritional intake.

The provider was not consistently meeting the requirements of the Mental Capacity Act 2005 (MCA) as care records did not always contain clear details about people’s capacity and were sometimes signed by people’s next of kin without clear evidence that they were authorised to do so.

The provider assessed the quality of the service, but these checks did not identify the issues we found in relation to people’s mental health records and ensuring their care was delivered in line with their valid consent.

The provider had suitable safeguarding systems in place for the prevention of abuse. Care staff had received safeguarding training and understood the usual signs of abuse and what to do if these occurred.

Recruitment procedures helped ensure candidates were safe to work with people. The provider conducted appropriate pre- employment checks to assess candidate’s suitability for employment within the service.

Medicines were managed safely and people received support with their medicines where needed. The provider conducted checks of medicines administration and took action to rectify issues where needed.

Care workers received an appropriate induction and ongoing training, supervisions and appraisals of their performance.

Care staff had a good understanding about people’s preferences in the way they wanted their care delivered. Care staff supported people to be as independent as they wanted to be.

Care workers ensured that people's privacy and dignity was respected and promoted.

The provider had an effective complaints procedure and people told us they would raise a complaint if needed.

The provider met the Accessible Communications Standard and communicated with people in person and in writing in a manner that suited their needs.