Archived: Eniola Care Ltd

Updated 19 April 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

• The inspection was undertaken by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert’s primary area of experience was with community based services and supporting people living with dementia.

Service and service type:

• Eniola Care Limited is a private Domiciliary Care Agency. The agency provides care and support for people in their own homes. The Care Quality Commission (CQC) regulates the care provided and this was looked at during the inspection.

• The service has a manager registered with the CQC. 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.

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Notice of inspection: We gave the service six days’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure they would be in. We also needed to obtain a list of service users and arrange visits.

• The Inspection included a visit to the office location on 19 and 20 February 2019 to see the registered manager and office staff; and to review care records and policies and procedures. We visited people in their own homes on 18 February 2019.

• The provider submitted a Provider Information Return (PIR) Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

What we did:

• Before the inspection we reviewed the information we held about the service. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used all this information to decide which areas to focus on during our inspection.

During the inspection we spoke with:

• The provider

• The registered manager

• The Head of Care

• Four care staff

• 13 relatives

• Seven people

After the inspection we spoke with:

• A social worker from the out of county hospital team

• A local authority Market Support Manager

During the inspection we reviewed the following documents:

• Notifications we received from the service

• Three staff personnel files

• Records of accidents, incidents and complaints

• Audits and quality assurance reports

• 11 care plans

During the inspection we considered the following risks:

• Falls

• Profile beds

• Safeguarding

• Home environment

• Risks to self

• Hygiene – use of personal protective equipment

• Nutritional neglect

• Medical risks

• Accessing the community

• Lone working

• Fire, electric, gas, water

Updated 19 April 2019

About the service: Eniola Care Ltd is a private domiciliary care agency. The agency originally had an office in Newhaven but moved to their current office in Lewes in May 2018. The agency provides care, support and personal care to people living in their own homes. At the time of this inspection care was being provided for 29 people.

Not everyone using Eniola Care received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasked related to personal hygiene and eating. Where they do we also take account of any wider social care provided.

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

People’s experience of using this service: People’s daily record sheets and Medicine Administration Records (MAR), were only returned to the office every two months. This meant that checks and audits could not be completed in a timely manner which resulted in some things being missed. For example, missing entries on MAR records. Also, a lack of detail with food and fluid intake with no specific measurements being recorded. Instructions for staff to manage a catheter were not recorded within a care plan. Although staff were aware of how to manage this recording of care provided required improvement.

There was no quality assurance for incidents or injuries. There had been no requests for written feedback from people, relatives or staff. The lack of auditing processes meant that best practice could not be captured and that there was no process to record lessons learned. These issues were discussed with the registered manager.

People told us they felt safe and were positive about staff. A person told us, “I feel much safer knowing that someone is checking on me as I worry about things.” A relative told us, “It’s very reassuring to know that (relative) has visits and when I go around there’re happy, clean and well cared for.” No safeguarding had been reported but all staff were aware of what to do if a situation arose. Staffing levels were sufficient. Medicines were managed safely.

Staff training was up to date and staff had the knowledge to meet people’s needs. Staff recruitment processes were robust. People were supported to eat and drink where needed although most people were supported in their homes by their families. Some people were living with dementia. Mental Capacity Assessments (MCA) had been completed by the local authority. No one was subject to Deprivation of Liberty Safeguards (DoLS).

People and their relatives thought that staff were caring and that people were well cared for. Staff

interactions were observed and it was clear that all were very attentive and understanding of people's needs. People's dignity and privacy was promoted. People were asked discreetly

if they needed support with personal care. Staff told us curtains were drawn and doors closed when providing personal care.

The service responded well to people’s needs. Person centred care was evident although not everyone reported being involved in their care planning. People living with dementia were spoken to kindly and time given to them to express their wishes. A person who was visually impaired required more support from care staff and this was discussed with the registered manager. No complaints had been made about the service.

The registered manager was well thought of by people, residents and staff. It was clear that she had a good knowledge of people and their support needs.

Rating at last inspection: Eniola Care Ltd have not been inspected by CQC before.

Why we inspected: This was a planned, comprehensive inspection. The inspection took place in line with CQC scheduling guidelines for adult social care services.

Enforcement: Action we have told the provider to take is included at the end of the report.

Follow up: We will review the service in line with our methodology for ‘requires improvement’ services.