Date of assessment 11 March to 30 July 2024. Eniola Care Limited is a domiciliary care service providing support and personal care to people in their homes. We visited the office on 30 July 2024. We previously visited this service on 11 and 19 March 2024. Since, our March 2024 assessment, there were significant changes at the service. The registered manager and deputy manager left along with several staff members. This left the service director (provider) with sole oversight, however they were not able to access computer systems where care data was held. The local authority had been supporting the service. Due to these changes the original assessment was paused. This report reflects our findings from our July assessment. We identified breaches in safe care and treatment, safeguarding, staffing and governance. There had been a significant turnover in staff at the service. Half of the care staff had been recruited since our visit in March 2024. Staff knowledge about what to do at a safeguarding incident was poor. Staff induction, supervision and training all required improvement. Some risk assessments were incomplete and none had been reviewed in the past 6 months. There were ongoing issues relating to medicines. Although some auditing was taking place, there were a number of areas where there was no management oversight. This included accident and incident analysis and inconsistent recording of staff supervision meetings and training. Feedback from people about the support they received was positive and staff reported improvements in communications with managers. We noticed improvements in the recording of mental capacity assessments and the reporting of significant events affecting the service to the local authority and CQC. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-12473072751.
Eniola Care Ltd was rated Requires Improvement overall (Inadequate for well-led) at its September 2022 inspection, representing a decline from its previous Good rating. Multiple regulatory breaches were identified spanning safeguarding, medicines management, risk assessment, consent, staffing training, notifications and governance, with a Regulation 17 warning notice served.
Concerns (16)
criticalSafeguarding: “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.”
criticalMedication management: “MAR just documented numbers, not the actual name of the medicines. Staff were not able to tell us about the side effects some medicines may create.”
criticalStaff training: “A person had a PEG feed through which medicines were administered. No staff at that time had received training in this area.”
criticalGovernance: “There were no auditing processes in place and quality assurance processes were inconsistent with no analysis of the views of people or their relatives.”
criticalIncident learning: “Not all accidents and incidents had been recorded. One incident had been recorded in the past 12 months... no steps had been taken to minimise the risk of similar events.”
criticalConsent / capacity: “There were no mental capacity assessments (MCA) in place for people needing help with making decisions.”
criticalLeadership: “The service had had four registered managers in the last 18 months, all of whom had left. The manager had not notified CQC of incidents they were legally obliged to.”
moderateCare planning: “Sections within care plans were headed 'About me' but in all cases these were blank. Care plans were not person centred.”
moderateSupervision / appraisal: “Supervision meetings were inconsistent, and few records kept. We were shown team meeting agendas but no minutes or actions were recorded.”
moderateEnd-of-life care: “There were no end of life care plans in place for people. Staff had not been trained in end of life care.”
moderatePerson-centred care: “Some people told us that they had requested female carers but this had never been provided despite repeated requests.”
moderateMissed or late visits: “"I have one half hour visit, they are here for 20 minutes" and "I'm being billed for 45 minutes and I get 20 minutes."”
moderateRecord keeping: “We saw gaps where medicines had not been recorded as being given although care notes recorded that they had.”
minorComplaints handling: “Not everyone knew how to raise issues or make a complaint. A person told us, "No I don't know who to contact. That's why I'm writing to the council."”
minorCultural competency: “Care plans had a section called 'About me.' However, these sections were blank... no details of people's cultural or spiritual needs recorded.”
minorCommunication with families: “"Their English is not amazing but they are comfortable with them now" and "there is a communication barrier on both sides."”
Strengths
· Sufficient staffing levels with every care call covered on rotas reviewed during inspection.
· Safe recruitment practices with DBS checks, photographic ID, references and work permits in place.
· Effective infection prevention and control measures with adequate PPE supplies.
· Staff treated people with kindness, dignity and respect, as confirmed by people and relatives.
· Manager maintained some positive relationships with health and social care professionals.
Quality-Statement breakdown (20)
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; staff induction, training and supportRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff working with other agencies to provide consistent, effective, timely careRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
caring: Ensuring people are well treated and supported; respecting equality and diversityRequires improvement
caring: Supporting people to express their views and be involved in making decisions about their careRequires improvement
caring: Respecting and promoting people's privacy, dignity and independenceRequires improvement
responsive: Planning personalised care to ensure people have choice and control; end of life careRequires improvement
responsive: Improving care quality in response to complaints or concernsRequires improvement
responsive: Meeting people's communication needs and supporting social inclusionRequires improvement
well-led: Managers and staff understanding quality performance, risks and regulatory requirementsInadequate
well-led: How the provider understands and acts on the duty of candourInadequate
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement
well-led: Continuous learning and improving care; working in partnership with othersRequires improvement