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E2E Homecare

Overall: Requires improvement read more about inspection ratings

The Axis Building, Maingate, Kingsway North, Team Valley Trading Estate, Gateshead, Tyne And Wear, NE11 0NQ (0191) 820 3483

Provided and run by:
E2E Homecare Ltd

All Inspections

During an assessment under our new approach

Date of assessment 30 May to 10 September 2024. At our last inspection the provider had breached the regulations relating to staffing and good governance. The provider was no longer in breach. The provider had enough staff and recruited new staff safely. Medicines administration records (MARs) were accurate and evidenced the medicines people had received from care staff. However, no MARs were available for topical medicines, such as creams. This was also an issue at the last inspection. Following our visit to the service the registered manager confirmed these were in place. Medicines competency assessments were also out of date. There were systems to record and review incidents. Although care staff had completed safeguarding training as part of the Care Certificate, they had not completed specific safeguarding training. Partners also felt the service could engage more proactively with safeguarding. Care plans usually contained person-specific risk assessments. Professionals had input into risk management. However, care plans were not always available for some people with specific health needs. The provider confirmed they would act on this immediately. The management structure and on-call arrangements were unclear in relation to conflicting information about some staff roles, oversight arrangements in the registered manager's absence staff access to some records. The provider’s website was not showing the current rating and advertising for services which the provider was not registered for. This has since been addressed. The provider had quality assurance processes, comprising of audits and checks on the service. The completed audits lacked detailed information about the findings, as well as containing little reflection about areas for improvement and lessons learnt. The provider’s service improvement plan identified future development plans for the service. However, it lacked specific timescales for delivering the improvements.

31 October 2023

During a routine inspection

About the service

E2E Homecare supports people to live in their own homes. The service provides personal care and support to children, younger adults and people of an older age, who may be living with a physical disability, sensory impairment, or mental health needs. At the time of the inspection the service was providing personal care to 19 people.

Not everyone who used the service received personal care. The Care Quality Commission (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.

People’s experience of using this service and what we found

Staffing levels and deployment were not always effectively managed. People told us they did not receive care from a consistent staff team, they had experienced missed calls and on occasions the calls were not at their scheduled times.

We were not assured staff had received all the appropriate training and supervisions to support people safely. We received mixed feedback from people and their relatives about the training of care staff.

The provider’s medicines management systems were not always effective.

Systems were not in place to effectively monitor and develop standards at the service.

The provider’s electronic care plans did not always provide concise guidance for staff about how to deliver people's care and support requirements.

Staff were recruited safely. Staff files contained appropriate immigration, sponsorship, and pre-employment checks; however, some records were incomplete.

People and their relatives told us some staff did not always listen to them, talk to them appropriately and in a way they could understand. As a result, this sometimes impacted on the quality of the care received.

People were not always happy with the support they received from staff at mealtimes.

The provider’s electronic care plans did not always provide concise guidance for staff about how to deliver people's care and support requirements.

Some people and their relatives were happy with the care and support they received from the care staff. One person told us, “The majority of the carers I have are very kind and supportive.” A relative told us, “The carers who come to assist (Name) have been brilliant, we could not ask for better.”

Policies and systems were in place to help ensure people were protected from the risk of abuse. Most of the people we spoke with during the inspection told us they felt safe in the presence of staff.

Support was personalised and based on people's assessed needs and preferences. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Risks to people’s health, safety and well-being were identified and managed. The provider had effective infection prevention and control systems in place.

The provider had systems for recording accidents and incidents, complaints and safeguarding concerns.

People and relatives were involved in making decisions about their care. People’s end of life decisions were respected.

People and relatives were aware of the provider’s complaints procedure and felt confident to raise concerns. Feedback was regularly sought from people and their relatives and valued. People and relatives felt the registered manager was approachable.

Most staff told us they were happy working at the service. They felt supported through their training, observations and supervision.

Staff worked with external professionals to ensure people received the support they wanted and needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 12 January 2023, and this is the first rated inspection.

Why we inspected

This was a planned inspection to rate the service and was prompted by a review of the information we held.

Enforcement and Recommendations

We have identified breaches in relation to staffing and good governance.

We have made a recommendation about communication.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.