Elmar Home Care Ltd - Horsforth

About the service

Elmar Home Care Limited – Horsforth is a domiciliary care service providing care and support to people in their own homes. The service was providing personal care to 63 people at the time of the inspection.

People’s experience of using this service and what we found

Right Support:

People’s risks were assessed, and their care plans developed in a person-centred way. However, care records did not always record when incidents had been followed up. People told us they received support in line with their assessed needs. People consistently told us their choices were promoted and respected by staff.

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.

Right Care:

Staff had completed the necessary training to meet people's needs and knew how to protect them from abuse and avoidable harm. Medicines were managed safely. Most people and relatives told us that they were involved in the development of their care plans and staff knew how to protect their privacy and dignity. There were good examples how people’s human rights were being protected through person-centred care plans, for example the provider used pictorial care plans and care plans in other languages as appropriate.

Right Culture:

The culture of the service supported people and staff in an inclusive way; enabling people to live their day-to-day lives as they chose to. The provider had quality assurance systems to regularly assess and monitor the service. However, these systems did not highlight staff recruitment and incident follow up concerns we identified. When things did go wrong, the provider did not routinely use lessons learnt to improve the service. The management team were proactive in addressing our feedback in relation to concerns identified during the inspection.

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 28 January 2020). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

Why we inspected

We received concerns in relation to the governance of the service. As a result, we undertook a focused inspection to review the key questions of safe effective, responsive and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elmar Homecare Limited - Horsforth on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified 1 breach in relation to safe recruitment at this inspection. We have made a recommendation about lessons learnt when things go wrong.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Elmar Home Care Limited is a domiciliary care service providing care and support to people in their own homes. The service was providing personal care to 34 people at the time of the inspection.

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

Most people felt safe when receiving care and support. Risks to people’s health and welfare were assessed but some improvements were needed to ensure a robust approach. People received their medicines safely.

Staff were recruited safely and followed an induction and training programme. Most people felt staff were well trained although one person’s relative felt staff lacked skills in supporting people living with dementia.

Most people said they had good relationships with staff and were complimentary of the care and support they received. People said staff took time to support them and respected their privacy and dignity.

Most people said they were involved in development and review of their care plans to make sure the support they received met with their assessed needs in the way they preferred. However, others felt the process for review of care was not always effective.

Some care records required review to make sure they fully and accurately reflected people’s needs and how staff should support them to meet their needs.

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. People had signed their consent to care plans and said staff respected their choices.

Staff were responsive to people’s health needs and liaised with healthcare professionals as needed.

People benefitted from initiatives such as support with social activities and staff spending time, between organised calls, to provide company and share meals.

The systems in place to monitor quality in the service did not always equip the provider with a robust overview of performance.

The management team were open about the difficulties they had experienced after taking on a large number of care packages from a previous provider. They had learned from this and had systems and processes in place to address issues and improve service.

People gave mixed feedback about the openness and person centred approach of the management team. Some had found the team to be responsive and supportive whilst others said they did not know the team and had not experienced an entirely person centred approach.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This was the first inspection of this service since it’s registration in November 2018.

Why we inspected

This was a planned inspection based on the date of registration.