Eniola Care Ltd

Eniola Care Ltd is a domiciliary care agency. The agency provides care to people living in their own homes. At the time of the inspection, care was being provided to 53 people. Some people lived with dementia and some people had support needs relating to their mobility or other health needs. Some people were in receipt of end of life care.

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

The service was overseen by a manager who was not registered with CQC. The manager had not notified CQC of incidents and events that they were legally obliged to, for example, safeguarding issues. There were no auditing processes in place and quality assurance processes were inconsistent with no analysis of the views of people or their relatives. Similarly, there were no processes in place to capture staff feedback. Supervision meetings were inconsistent, and few records kept. We were shown team meeting agendas but no minutes or actions were recorded.

Staff knowledge of what safeguarding meant and steps they would take if a person was at risk was lacking. Although most people told us they felt safe this was not reflected in what we heard listening to the manager and staff. The manager told us that no safeguarding issues had been raised by the service however we were told by the local authority that four had been raised in the past 18 months. Not all risk assessments were in place to help staff manage risks. For example, dementia, Parkinson’s disease and diabetes assessments were missing in some people’s care plans. Medicines were not always safely managed with information absent about what the medicines were for and no risk assessments to manage side effects. Not all accidents and incidents had been recorded and no patterns or trends had been identified.

When agreeing to support new people the manager had not thoroughly assessed people’s needs. For example some people used urinary catheters but staff had not been trained in catheter management. Staff received a three day induction which included some basic training modules. There was no evidence to suggest any further, effective training was provided for staff after their induction.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. People had not been supported to attend health and social care appointments but the manager told us the service could provide this support if required.

Some people told us that they had requested female carers but this had never been provided despite repeated requests. Sections within care plans were headed ‘About me’ but in all cases these were blank.

People told us that the length of care calls varied and that they were not always informed if carers were running late. Care plans were not person centred. Each section began with a heading, ‘What I can do.’ However, there was no information describing what people could do for themselves but a description of the support needed. A complaints policy was in place but not everyone we spoke to knew how to raise a complaint or concern. Four complaints were recorded, all related to late calls. Some people supported were towards the end of their lives. There were no end of life care plans and staff had not been trained in end of life care.

There were enough staff and staff had been recruited safely. Infection prevention and control measures were in place. People told us that they were treated with dignity and respect and that their independence was encouraged without compromising their safety. People’s privacy was respected. Some people did tell us that they thought the manager was helpful and some staff told us that the manager had supported them well. Some contingency plans were in place and the manager had developed some positive relationships with health and social care professionals.

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 good. (Report published 19 April 2019)

Why we inspected

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

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive 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 Eniola Care Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to safeguarding, risk, medicines, training and ongoing staff support, mental capacity assessments, statutory notifications, auditing and quality assurance. We served a regulation 17 warning notice to the provider to be complied with by 30 December 2022.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.