Elm Tree Care Services

Updated 16 October 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own home.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small, and people are often out. Inspection activity started on 20 September 2021 and ended on 29 September 2021. We visited the office location on 29 September 2021

What we did before the inspection

We reviewed information we had received about the service since it was registered. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three relatives about their experience of the care provided. One relative told us their family member had recently stopped using the service as their family member now required full time care. We spoke with the registered manager, care co-ordinator and administrator at our office visit. We also obtained feedback from one of the healthcare assistants.

We reviewed a range of records. This included two people’s care records and two staff files. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 16 October 2021

About the service

Elm Tree Care Limited is a service providing care and support to people in their own home. At the time of the inspection the service was providing support to three people. All the people using 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

Relatives felt their family members were safe using the service. The assessment of people’s risks required improvement to ensure they covered all areas of a person’s activities. The service was not supporting anybody with their medicines at the time of the inspection. People were supported by a regular team of care workers. There were enough care workers to meet people’s needs. However, the contingency plans in place to cover unexpected staff or registered manager absence needed to be more robust. The service’s recruitment procedures required improvement. The registered manager assured us they would take immediate action to ensure safe recruitment procedures were always followed.

Relatives were confident care workers had received appropriate training to meet their family member’s needs. However, there were no records to show staff had received appropriate induction training prior to supporting people. Staff had not received any formal supervisions since they started working at the service.

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 support this practice.

Relatives told us care workers were kind and caring and treated their family member with dignity and respect. People’s independence was promoted by care staff.

People’s needs were assessed, and people and relatives were fully involved in their care planning. The service liaised with professionals where required. We made a recommendation to the provider about Accessible Information Standard (AIS).

Relatives and staff made positive comments about management of the service. However, the provider had not ensured quality assurance systems were in place to systematically check the quality of the service and manage risks.

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

Rating at the last inspection

This service was registered with us on 23 July 2020 and this is the first inspection.

Why we inspected

This was a planned inspection to provide the service with a rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective 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.

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 have identified breaches in relation to the recruitment of staff, the management of people's risks, staff training and supervision and quality assurance at this inspection. 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.