Enham Trust - Care & Support at Home was rated Requires Improvement overall following a September 2022 inspection, with Safe and Well-Led both deteriorating from Good, primarily due to insufficient staffing levels causing late calls and over-reliance on agency workers. Governance and care planning improvements were underway but not yet fully embedded at the time of inspection.
Concerns (5)
moderateStaffing levels: “"Staffing levels are a major problem as there's only two full time carers and the other three have limited availability so the two full-time carers end up having to pick up extra hours"”
moderateMissed or late visits: “"A few late calls. If the carer is 15 minutes late there is an on-call number" and "I was waiting for my lunch call...They told me the person hadn't come to work"”
moderateGovernance: “Actions plans were in place which highlighted that various policies and procedures required updating to reflect best practice. Additional time was required to fully embed the planned improvements.”
minorCare planning: “Further development with some care plans was required to ensure best practice was consistently applied. The registered manager acknowledged this and was in the process of making the required changes.”
minorPerson-centred care: “"They have to use a lot of agency workers that means I keep having to explain my care every shift"”
Strengths
· Safe recruitment processes in place; staff files met all Schedule 3 requirements including DBS checks
· Medicines managed safely with accurate MAR records and effective governance systems identifying errors
· Staff were knowledgeable about safeguarding responsibilities and able to describe types of abuse and reporting routes
· Infection control managed well; staff had access to and used appropriate PPE
· Provider had arrangements to obtain feedback from people and relatives; June 2022 survey showed general satisfaction
Quality-Statement breakdown (10)
safe: Staffing and recruitmentRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Planning and promoting person-centred, high-quality care and support with opennessGood
well-led: Continuous learning and improving careRequires improvement