Eaves Court is a small domiciliary care service rated Good overall, with people reporting positive, person-centred care and staff demonstrating strong safeguarding knowledge and compassion. The Well-Led domain requires improvement due to ineffective quality assurance systems, incomplete incident records, lack of audit follow-through, and poor record-keeping around care changes.
Concerns (5)
moderate
Governance
: “Information gathered by the service was not effectively analysed and used to drive improvements to the quality and safety of the service.”
moderateIncident learning: “Accidents and incidents which had been recorded in January 2019, still open on the system and had not recorded the action taken to prevent a re-occurrence.”
moderateRecord keeping: “Clear records were not routinely maintained of all communication made about people and any changes in their care needs.”
moderateGovernance: “No plan of action was devised in response to this audit. This meant the service had not taken appropriate action without delay.”
minorStaff competency: “The service did not always explore gaps in employment histories or obtain a reason why the staff had left a previous role.”
Strengths
· People and relatives gave consistently positive feedback, with comments including 'I cannot speak highly of them' and 'Excellent, very comforting and reassuring.'
· Staff were knowledgeable about safeguarding, knew how to recognise abuse, and had confidence to report concerns.
· Medicines were managed safely, with trained and competent staff and routinely completed MAR records.
· Person-centred care planning included life histories, cultural needs, and preferred activities, with people involved in developing and reviewing their care plans.
· Staff received a structured induction including shadowing and completion of the Care Certificate.
Quality-Statement breakdown (20)
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongRequires improvement
effective: Ensuring consent to care and treatment in line with law and guidanceGood
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 and access healthcare servicesGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
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 meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Planning and promoting person-centred, high-quality care and support with openness; duty of candourRequires improvement
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: Engaging and involving people using the service, the public and staff; working in partnership with othersGood