Essex and Suffolk Quality Care provides personal care and support to people who require assistance in their own home. This service is a domiciliary care agency. At the time of our assessment 37 people were being supported by the service. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At our last assessment on 19 May 2022, we found the provider was in breach of the regulations in relation to person centred care, safe care and treatment, safeguarding people from harm, good governance and safe recruitment. We carried out an announced on-site comprehensive assessment on 14 May 2025, offsite activity started on 12 May 2025 and ended on 20 May 2025 to review improvements made since the last assessment. We found the provider had made improvements in all areas and was no longer in breach of the regulations. The registered manager now had systems in place to monitor the service, which provided good oversight to monitor and improve outcomes for people.
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Essex and Suffolk Quality Care Ltd was rated Requires Improvement overall, with breaches identified in person-centred care, safe care and treatment, safeguarding, recruitment and good governance. Significant concerns included missed and late visits not being monitored, unsafe medicines management, inadequate risk assessments, weak recruitment checks and ineffective oversight by leadership.
Concerns (14)
criticalMedication management: “in one person's MAR, the amount of medicines to be given to them was not recorded, therefore staff would not know how many were to be administered”
criticalMissed or late visits: “Systems were not in place to monitor missed and late visits. Some people had missed visits which put them at risk of harm.”
criticalSafeguarding: “The provider did not always recognise and act upon the potential safeguarding implications of how people were affected by missed and late calls.”
criticalGovernance: “Systems or processes were not being operated effectively for the management and oversight of the service.”
criticalCare planning: “care plans did not provide adequate information about how to meet people's needs. This was a continued breach of Regulation 9”
criticalOther: “We found gaps in the employment history of staff which had not explained or recorded in all the files we looked at.”
moderateStaff competency: “Assessments on staff members competency to administer medicines were not robust. We saw one assessment which had been completed with one staff member over the phone.”
moderateStaff training: “no oral hygiene training, basic first aid or pressure care management training was shown to be in place.”
moderateRecord keeping: “Written paperwork such as daily notes and medicine administration records were illegible and disorganised”
moderateInfection control: “The provider's infection prevention and control policy and COVID-19 policy did not follow good practice guidance and had not been reviewed”
moderateConsent / capacity: “There was little evidence of formal capacity assessments or detailed best interest decision making within the care plans of people living with dementia.”
moderateIncident learning: “no analysis of trends and common themes were looked into to ensure they didn't happen again.”
moderateCommunication with families: “over half of people said they were not happy with communication and being informed of changes.”
moderateLeadership: “I really feel that the office and management is a real problem. They do not listen.”
Strengths
· There were enough staff employed to provide the required care for people; most staff confirmed they were not rushed.
· Improvements had been made in meeting the Accessible Information Standard and recording oral healthcare and sensory needs.
· The provider logged and responded to complaints from people and relatives, investigating and apologising where appropriate.
· Staff received an induction, three-monthly supervision and annual appraisals; team meetings had commenced.
· The provider worked with other professionals such as GPs, occupational therapists and district nurses.
Quality-Statement breakdown (20)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Staffing and recruitmentNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Learning lessons when things go wrongNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff working with other agencies; supporting people to access healthcareNot rated
effective: Mental Capacity Act 2005Not rated
responsive: Planning personalised care to meet needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: Supporting people to develop and maintain relationships and follow interestsNot rated
responsive: End of life care and supportNot rated
well-led: Promoting a positive, person-centred culture and duty of candourNot rated
well-led: Managers and staff understanding roles, quality, risk and regulatory requirementsNot rated
well-led: Engaging and involving people, public and staffNot rated
well-led: Working in partnership with othersNot rated