East Midlands Homecare Limited received an overall rating of Good across all five key questions at its July 2019 inspection, with 48 people receiving personal care. Minor gaps were noted in risk guidance linkage to care plans, medicines recording, and end-of-life care planning, all of which the registered manager committed to address during or after the inspection.
Concerns (4)
minor
Care planning
: “There was limited guidance for staff on how to support people with identified risks and these were not always clearly linked to people's care plans.”
minorMedication management: “Some medicines administration records did not always clearly detail all of people's medicines.”
minorMissed or late visits: “Some people felt distress when the calls had previously been late.”
minorEnd-of-life care: “There was limited information within people's care plans regarding their end of life wishes. The provider told us they would develop care plans following our inspection.”
Strengths
· People felt safe and staff demonstrated good knowledge of safeguarding responsibilities.
· Robust pre-employment checks carried out on all staff members.
· Comprehensive induction including shadow shifts and the Care Certificate for inexperienced staff.
· Specialist training delivered by relevant healthcare professionals for complex needs such as catheter care and PEG.
· Staff encouraged people's independence and treated them with dignity and respect.
Quality-Statement breakdown (25)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
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: Staff working with other agencies to provide consistent, effective, timely careGood
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: 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: 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: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood
East Midlands Homecare Limited was rated Good across all five key questions at its September 2016 inspection, demonstrating safe staffing, effective medicines management, compassionate care and robust governance. The sole area for improvement was the absence of routine pressure sore and malnutrition risk assessments, which the provider agreed to address during the inspection.
Concerns (1)
moderateCare planning: “the provider was not routinely assessing risk of pressure sore development or the risk of malnutrition.”
Strengths
· No missed calls in the previous 12 months; staffing rosters allowed adequate travel time between calls
· Staff had received safeguarding training and knew how to recognise abuse and report to appropriate authorities
· Medicines management was safe, with staff training, competency assessment and ongoing spot checks
· Staff were deployed consistently so people were supported by familiar carers, reducing anxiety
· Complaints were responded to promptly and used to drive learning and improvement