27 July 2023
During an inspection looking at part of the service
Eldercare is a domiciliary care service providing regulated activity of personal care. At the time of the inspection 18 people received the service in their own homes. The service is registered to provide support to people who misuse drugs and alcohol, people with an eating disorder, and people with dementia, mental health, learning disabilities or autistic spectrum disorder.
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
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
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.
Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.
Right support: 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.
Staff were safely recruited in line with the provider's policy and legislative requirements. Staff received supervision and appraisal along with spot checks to ensure they followed best practice guidance.
People received initial assessments of their needs with care plans in place to manage known risks.
Regular reviews ensured information remained relevant and up to date as an accessible point of reference for staff. For example, policies and procedures had been updated to ensure the safe and secure management associated with people’s finances, where this was required.
Right care: Care was person-centred and promoted people's dignity, privacy, and human rights;
Staff were respectful, caring and understanding around people’s emotional and physical needs.
Where people were assessed as requiring support to take their medicines this was completed by suitably skilled staff with information available for staff to follow to do this safely. Guidance to support staff in ensuring people received other medicines when they required them, for example, pain relief, and application of prescribed creams was available and will benefit from a required review to ensure guidance remained clear and always followed best practice protocols.
Right culture: The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services led confident, inclusive, and empowered lives; The culture of the service was open and empowered individuals to express their views and be in control of their lives with the support of staff. People felt confident to approach staff and management and that their suggestions were listened to.
People were involved in planning their care and support and delivered following a robust assessment of needs to ensure people’s wishes, preferences, and any personal characteristics were recorded and supported.
A range of quality assurance checks including regular audits were completed to manage and improve the service and to maintain compliance with required regulations.
Staff followed latest guidance to maintain effective infection prevention and control and had good access to any required protective equipment which helped to reduce the spread of any infections.
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 was Good (published 30 October 2018).
Recommendations
We have made a recommendation for the provider to review information to manage ‘as and when required’ medicines to ensure the implementation of best practice protocols and guidance for staff to follow.
Why we inspected
The inspection was prompted in part by a CQC notification of allegations of financial abuse against a person in receipt of regulated activity. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk associated with supporting people where their money was involved.
We undertook a focused inspection to review the key questions of safe and well led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We found no evidence during this inspection that people were at risk of harm from this concern.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eldercare on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.