This focused KLOE inspection of Elizabeth's Rose Home Care confirmed improvements since the previous 'Requires Improvement' rating, with Safe, Effective and Well-led all now rated Good. The service demonstrated effective risk assessment, safe medicines management, personalised care planning, and strong leadership culture, resulting in an overall rating uplift to Good.
Strengths
· Comprehensive risk assessments documented in care plans, including clinical conditions such as diabetes and mobility risks
· Staff skills matched people's needs; administrative and operational staff also trained in care to maintain staffing levels
· Safe recruitment processes followed including DBS checks, identification and references
· Medicines managed safely with staff trained to administer and record administration appropriately
· Needs and choices assessed prior to delivering care, with personalised care and support plans
Quality-Statement breakdown (16)
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and support with other agenciesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
Elizabeth's Rose Home Care received an overall rating of Requires Improvement at its first inspection, with gaps identified in risk assessment, care planning, staff competency for specialist needs, and medicines information management. The service demonstrated genuine strengths in its caring culture, reliable visit attendance, person-centred practice, and responsive communication with families and external agencies.
Concerns (5)
moderateCare planning: “Some peoples care plans did not include assessments of risks relating to their clinical conditions.”
moderateStaff competency: “Skills staff did not always match the needs of people using the service. The registered manager had not ensured all staff had appropriate skills and knowledge to support people with specific needs such as those requiring stoma care.”
moderateMedication management: “Staff did not have access to information about the specific medicines for some people, including potential side effects.”
moderateGovernance: “There were not established and effective systems in place to ensure the consistent and appropriate identification, assessment and management of clinical and mobility risks.”
minorCare planning: “The registered manager had not consistently assessed people's needs and choices prior to providing care. Staff had supported a person prior to their preadmission information being formally assessed.”
Strengths
· Staff were described by relatives as 'Really good, can't fault them' and always spent the allotted time with people.
· Safe recruitment processes were followed, including DBS checks, identification and reference verification.
· People were supported to have maximum choice and control, with staff working in the least restrictive way possible.
· Strong person-centred culture with staff committed to dignity, respect and promoting independence.
· Effective communication with families including a remote app to review care notes and medication records.
Quality-Statement breakdown (25)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood