Archived: Efficiency- For Care

Updated 9 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was carried out on 21 May 2018 and was announced. We announced our inspection because we wanted to be certain that someone would be available to support us. The inspection was undertaken by one inspector.

Before the inspection, we reviewed relevant information that we had about the provider including any notifications of safeguarding or incidents affecting the safety and wellbeing of people. A notification is information about important events which the provider is required to tell us about by law. We also received a Provider Information Return (PIR) from the service. A PIR is a form that asks the provider to give some key information about the service, what it does well and any improvements they plan to make.

Before the inspection, we spoke with one person’s relative and two staff.

During the inspection, we spoke with the director, manager, operations manager and care-coordinator, who was also a care staff member.

We reviewed documents and records that related to people’s care and the management of the service. We reviewed two people’s care plans, which included risk assessments and six staff files which included pre-employment checks. We looked at other documents held at the service such as medicine, training, supervision and quality assurance records.

After the inspection, we spoke to one relative.

Updated 9 June 2018

We carried out an announced inspection of Efficiency-For Care Limited on 21 May 2018. Efficiency-For Care Limited is registered to provide personal care and treatment of disease, disorder and injury to people in their own homes. At the time of our inspection, the service provided personal care to two people in their homes.

During our last inspection of the service on 9 October 2017, we found significant shortfalls that placed people at risk of harm. The service was in breach of regulations of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014 in association with risk assessments, medicine management, staff training and good governance. Following the inspection, we took urgent enforcement action to ensure the service made improvements. During this inspection, we found improvements had been made and the service has now been rated Good.

The service did not have a registered manager. There was a manager in place who had applied to be registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Relatives told us that medicines were given on time. However, there were discrepancies in people’s medicine records as records had not been kept of topical cream administration. We made a recommendation in this area.

Risks had been identified and information had been included on how to mitigate risks to ensure people received safe care. Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and outside the organisation.

Pre-employment checks had been carried out to ensure staff were fit and suitable to provide care and support to people safely. Staff told us they had time to provide person centred care and had enough staff to support people. There were systems in place to reduce the risk and spread of infection. Staff had been trained on infection control and were provided with personal protection equipment to ensure risks of infection were minimised when supporting people.

Staff had received the training required to perform their roles effectively. This also included specialist training to support people with specific health conditions.

Staff had not been trained on the Mental Capacity Act 2005 and some staff we spoke to did not know the principles of the act. After the inspection, we received confirmation that training had been booked in this area. Assessments had been carried out using the MCA principles by the management team and best interest decision made with family and health professionals where people did not have capacity to make certain decisions.

People were cared for by staff who felt supported. Spot checks had been carried out to observe staff performance to ensure people received the required care and support. People’s care and support needs were assessed regularly for effective outcomes. The service worked with health professionals if there were concerns about people’s health. Staff could identify the signs people gave when they were not feeling well and knew who to report to.

People had a positive relationship with staff. Relatives told us that staff were caring. People’s privacy and dignity were respected by staff. People and relatives were involved in making decisions about their care.

Care plans were person centred and detailed people’s preferences, interests and support needs. Relatives knew how to make complaints and staff were aware of how to manage complaints.

Staff told us the culture within the service was open and transparent and told us the service was well-led. Relatives and staff were positive about the management team. People’s feedback was sought from surveys and reviews meetings.