Excel Care Group, a domiciliary care agency specialising in end of life care, was rated overall Good at its first inspection, with Safe rated Requires Improvement due to inconsistent logging of care calls and medication administration records on its monitoring app. Strengths included compassionate, person-centred care, effective multi-agency working, and a supportive registered manager who was responsive to improvements throughout the inspection.
Concerns (5)
moderateRecord keeping: “Staff were not consistently logging into calls to record that the call had taken place... there were still a significant number of calls which looked like they had been missed”
moderateCare planning: “There was not sufficient information in care plans to direct staff about the correct amount of thickener to be used.”
moderateMedication management: “Medicines were not always recorded as administered when staff had not logged into the care calls on the monitoring app.”
minorCare planning: “Care plans were not always personalised to reflect how the individual would like to be supported.”
minorGovernance: “The audit had identified areas to improve. There was no action plan in place to monitor the progression.”
Strengths
· Staff were recruited safely with thorough reference checking processes.
· Staff received a combination of online and face-to-face training including the Care Certificate and NVQs.
· People and relatives consistently praised the kindness, compassion and professionalism of staff.
· The service specialised in end of life care, with staff trained and passionate about supporting people with dignity at end of life.
· The service worked well in partnership with other healthcare professionals.
Quality-Statement breakdown (25)
safe: Staffing and recruitmentGood
safe: Assessing risk, safety monitoring and managementRequires 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 lawGood
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
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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: End of life care and supportGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
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: 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