Executive Carers

Updated 14 January 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors. Inspectors also made phone calls to staff as part of the inspection. An Expert by Experience also made phone calls to people and relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At this service, the registered manager and the provider are the same person. We refer to them as the provider throughout this report. Following our visit, a new manager started at the service, although they had not yet registered with us.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on 8 October 2021 and ended on 29 October 2021 once we had contacted people, relatives and staff over the phone. We visited the office location on 8 October 2021.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we had received about the service. We asked Healthwatch if they had any information to share about the service, which they did not. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We sought feedback from the local authority, and they shared the feedback they had received about the service. We used all of this information to plan our inspection.

During the inspection

We spoke with seven people who used the service and seven relatives about their experience of the care provided. We had discussions with seven members of care staff, including care assistants and a care coordinator. We also spoke with the provider and the consultant the provider had engaged to support the service. We also spoke with another professional who had worked in partnership with the service.

We reviewed a range of records. This included seven people’s care records and some of their medication records plus multiple care notes. We looked at five staff files in relation to recruitment and staff supervision. We also looked at a variety of records relating to the management of the service, including audits and policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, some additional care documents and quality assurance records.

Updated 14 January 2022

About the service

Executive Carers is a home care service registered to provide personal care. People are supported with their personal care needs to enable them to live in their own homes and promote their independence. At the time of the inspection the service supported 70 people.

Not everyone who used the service received personal care. 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

Staff were overall recruited safely, however we have made a recommendation to ensure this was more robust and areas which needed exploring and documenting were fully recorded. Overall medicines were managed safely, however instructions for ‘when required’ medicine and the recording of topical medicines needed improvement. We have made a recommendation about improving medicines processes. The provider had not recognised the need to carry out decision-specific mental capacity assessments. Systems had not identified omissions in some medicines procedures and recruitment. Action was taken to address these following our feedback.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not fully support this practice. However, action was taken to address this in response to our feedback.

There were enough staff to support people safely and people generally had their calls on time. Action was taken in response to accidents and incidents. People were protected from the risk of abuse by staff who understood their safeguarding responsibilities. People felt safe whilst being supported and risk reduction measures were in place to help protect them. People were protected from the risk of cross infection.

Staff received training and support to be effective in their role. People were supported to have enough food and drink of their choice to keep them healthy. People had their needs assessed and planned for and could access other health and social care professionals when necessary.

People were supported by staff who were kind and caring and treated them with dignity and respect. People had their protected characteristics considered. People were supported to make decisions about their care. People were supported to remain independent and have privacy.

People had personalised care plans in place so staff could get to know them. People generally felt involved in developing their care plans. People were supported to maintain relationships and avoid social isolation. People were supported to access information and communicate in a way that met their needs. Complaints were recorded, investigated and responded to. The provider had measures in place should they support people nearing the end of their life.

People, relatives and staff felt positively about the provider. Staff felt appreciated in their role. The provider understood their duty of candour. People, relatives and staff were asked for their opinions about the service. The provider worked in partnership with other organisations and professionals. The provider used their experience to continuously learn and improve.

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

Rating at last inspection (and update)

This service was registered with us on 29 January 2021 and this is the first inspection. The last rating for the service under the previous provider was requires improvement (published 6 August 2020). At this inspection under this provider, they have been rated good overall (requires improvement in well-led).

Why we inspected

We received information that the provider had used inappropriate terminology when referring to a person they supported. The provider had also changed their registration with us and had not had an inspection to check their rating since this change, prior to this inspection. We discussed the terminology used by the provider, who was remorseful. We did not find any other instances of inappropriate terminology being used by them or any other staff during this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.