11 April 2018
During a routine inspection
Excellence Healthcare is a domiciliary care agency registered to provide personal care to people living in their own homes. At the time of the inspection the service supported nine people.
The registered manager was also the provider. 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.
At our previous inspection in January 2017 we rated the service as 'Requires Improvement' as the service was not always safe because staff did not consistently have the information they required to ensure that people were protected against identified risks. It was not always clear whether people were receiving their medicines as prescribed. People's rights were not always protected because the provider was not aware of their responsibilities to ensure that care was provided lawfully. The provider had failed to respond to some of the improvements that were recommended at our inspection in January 2016. The provider had some management systems in
place to assess and monitor the quality of the service provided to people. However, some of these were not always used effectively to manage risks and to identify where improvements were needed. On this inspection we found improvements had been made and although there was some further improvement to be made, the overall rating for the service was now Good.
The provider had improved their quality assurance systems. However, further improvement was required with the consistency of updating and reviewing care plans and risk assessments, that ensured they were up to date, accurate and reflective of people’s needs and choices. The provider had taken steps to ensure they were kept up to date with current legislative practices however, their knowledge around protecting people’s rights required further improvement.
People felt safe in their homes with staff. Relatives were confident their family members were kept safe. Staff knew what action they would take if they thought a person was at risk of harm. Risks to people were assessed and people were supported by staff that was provided with guidance on how to manage people’s specific medical conditions.
People were supported by sufficient numbers of staff that had been safely recruited. Where appropriate, people were supported with their medicines by staff that had received training. Staff members were equipped with sufficient personal protection equipment to reduce the risk of infection and cross contamination when supporting people with their personal care.
Staff were trained to ensure that they had the skills to support people effectively. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to make decisions about how they wanted to receive support to ensure their health needs were met. Where appropriate, people required assistance to eat and drink. Timely referrals were made to health and social care professionals when people’s needs changed.
People had a small team of staff who provided their support and had caring relationships with them. Care was planned and reviewed with people and their family members to ensure their choices were followed. People's privacy and dignity were respected and upheld by the staff. People had care records that included information about how they wanted their care and this was reviewed to reflect any changing needs. There was a complaints procedure in place and any concerns received were investigated and responded to in line with the provider’s policy. People, their family members and professionals were asked for their feedback on the quality of the service. The provider promoted an open culture which put people at the heart of the service.