Endurance Health Ltd

Updated 12 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 3 and 6 August 2018. This was a comprehensive announced inspection. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that staff would be available in the office to assist with the inspection. The inspection was completed by one inspector over both days. The first day was based on site and consisted of looking at all paperwork for the service. The second day was allocated to completing telephone interviews with people who use the service, relatives, and professionals.

Prior to the inspection the local authority care commissioners were contacted to obtain feedback from them in relation to the service. The service is predominantly provided to privately funded people therefore we received minimal feedback. We referred to previous inspection reports, local authority reports and notifications. Notifications are sent to the Care Quality Commission by the provider to advise us of any significant events related to the service. As part of the inspection process we also look at the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We had received the PIR for Chrome Tree House Ltd and used this to help inform our inspection plan.

During the inspection we spoke with seven members of staff, including four care support workers, two senior managers based in the office and the registered manager. We further sent out surveys to nine care staff, five relatives and six people who use the service. We further spoke with four people who are supported by the DCA staff and two relatives on the second day of the inspection, by telephone.

Care plans, health records, additional documentation relevant to support mechanisms were seen for six people. In addition, a sample of records relating to the management of the service, for example staff records, complaints, quality assurance assessments and audits were viewed. Staff recruitment and supervision records for six of the regular staff team were looked at.

Updated 12 September 2018

This inspection took place on 3 and 6 August 2018. This was an announced inspection as Chrome Tree Ltd is a Domiciliary Care Agency (DCA) and we needed to be sure someone would be at the office. A DCA is a provision that offers specific hours of care and support to a person in their own home. The service currently supported 72 people with the regulated activity of personal care, and employed 32 staff on a zero hours contract.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of the inspection a registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service remained safe. Sufficient staff were employed to manage people’s needs, and enable them to engage in activities of their choice, through appropriate risk management. Staff knew how to safeguard people from abuse and were aware of the protocols to follow should they have concerns. Staff reported that they would not hesitate to whistle-blow if the need arose. Where staff were involved in medicine management, these were managed safely. Staff were competency checked annually and audits were completed to ensure people were kept safe.

The service had improved in the domain of effective. Systems were now in place to ensure records were maintained for any best interest decisions made by the service. Support continued to be delivered by a trained staff team, who were able to respond appropriately to people’s changing needs. Staff were supervised and supported by an effective management team, who made certain they were available to staff at all times. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service remained caring. Staff were reported to be polite, respectful and ensured they maintained people’s dignity when supporting them. They encouraged open communication and worked on motivating people to increase their independence. Evidence of using systems of communication that reflected the person’s choice was evident. Where concerns had been identified of staff proficiency in English, the service considered ways to make improvements.

The service remained responsive. Care plans were individualised, focusing on people’s specific needs. The service took necessary action to prevent and minimise the potential of social isolation. People and staff were protected from discrimination. Measures were in place to allow people to be treated equally. Systems to monitor and investigate complaints were in place, with detailed records maintained.

The service had developed methods of good governance, that provided real time evaluation of practice. A thorough quality assurance audit was completed annually with an action plan being generated, and followed up on. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management . The service was well-led.