Elite Care Services Limited

Elite Care Services are located in Bedford. The service is registered to provide personal care for people who may live with learning disabilities or autistic spectrum disorder, sensory impairments, dementia and younger adults and people living with mental health conditions.

People live in their own homes and receive support to enable them to live their lives as independently as possible either under supported living arrangements or domiciliary care. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support including help with tasks related to personal hygiene and eating. At the time of this inspection 14 people received personal care from Elite Care Services.

At our last inspection in October 2015 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 on-going 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.

The service had a registered manager. 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.

Staff were trained to recognise the various forms of abuse and encouraged to report any concerns.

Risks to people’s safety were assessed and planned for. Recruitment systems were robust and there were enough staff members available to meet people’s needs safely. The arrangements for the administration of medicines were robust. The provider had appropriate infection control procedures in place and personal protective equipment (PPE) was available in people’s homes for staff to use. Personal emergency evacuation plans had been developed to guide staff how to support people to leave their homes in the event of an emergency situation.

People received effective care because they were supported by a staff team who received regular training and had a good understanding of people's needs. New staff members completed a comprehensive induction when they commenced employment with Elite Care Services. Staff received support from the management team as needed. People were supported to use technology and equipment to promote their independence where appropriate. People were supported to maintain a healthy diet as part of their support plan. Staff supported people to access healthcare appointments as needed and liaised with health and social care professionals involved in their care if their health or support needs changed. Elite Care Services worked effectively with other health and social care services to help ensure people's care needs were met.

People told us that the care workers were all kind and caring. People received their care and support from a small stable team of care workers which helped to ensure that people’s dignity and privacy was respected. Staff provided help in a way that was sensitive to each person’s individual needs and encouraged support and involvement. People’s confidential information was protected appropriately in accordance with data protection guidelines. People’s dignity and privacy was respected and promoted.

People received care and support that was responsive to their needs because staff were aware of the needs of people who used the service. People’s care plans clearly detailed how they wished staff to provide their care. People were supported to take part in activities that they enjoyed and wanted to do. The provider had a complaints policy and procedure however, had not received any formal complaints since the previous inspection.

Relatives of people who used the service told us that they thought Elite Care Services was well-led. Staff told us they were proud to work for Elite Care Services. The registered manager demonstrated an in-depth knowledge of the staff they employed and people who used the service.

Staff told us that the management team was approachable and that they could talk to them at any time. The provider had a system of governance in place that helped them to satisfy themselves that the service was safe, effective, caring, responsive and well-led. People were supported to give feedback about the service they received. The service had an open and transparent culture with all relevant external stakeholders and agencies.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

We found that people's needs had been appropriately assessed before care was commenced. We saw that their needs were regularly reassessed to ensure they received safe care. We looked at four care records and found that there was sufficient detail to ensure that risk assessments were effective and that staff understood how they could minimise risk while ensuring people's independence was maintained. This meant that staff had the information they needed to minimise identified risks to people's safety and welfare.

All of the four family members we spoke with told us the care staff treated their relative well and did what was expected of them. Information obtained from recent feedback questionnaires stated that, 'I have found the carers to be sensitive, thoughtful and efficient in their care.' One relative told us, 'They support him really well and he is able to enjoy a good quality of life.'

There were sufficient numbers of experienced and competent staff on duty to safely meet people's personal and health care needs. We saw that staff had been appropriately trained and received effective support from managers so that they could undertake their roles safely. The staff we spoke with were knowledgeable about people's care and support needs.

Staff had received training in the protection of vulnerable adults and the staff that we spoke with knew how to report concerns. We saw evidence that incidents or accidents had been appropriately reported to the Local Authority and the Care Quality Commission (CQC). This meant that people were protected from the risk of neglect or unsafe care.

Suitable arrangements were in place to respond to emergencies, with the manager or provider always being available 'on call' to support staff to manage issues safely, and in a timely way. The registered manager told us, 'We are always there to help out, no matter when.'

Is the service effective?

People's health and care needs had been assessed and care plans were in place. There was evidence that people had been involved in planning and agreeing their care, and the care plans provided staff with enough detail to ensure care could be delivered in a consistent manner and met people's assessed needs. One relative told us, 'They spent time making sure that the needs could be met and we have never looked back.' Staff were able to tell us about people's individual needs and how they delivered their care. This meant that because staff had a good knowledge of each person's care needs and preferences they were able to provide effective care.

Staff had received the robust information, training and support they needed to do their job effectively. There were arrangements in place that ensured staff had the most up-to-date information about people's needs. This included 'handovers' of relevant information for staff in the supported living part of the service and regular meetings for other staff.

Is the service caring?

We spoke to the relatives of four people who used the service. They told us that all of the staff were kind and provided a good standard of care. We were told that staff interacted with people in a patient, kind, and gentle manner. Feedback we saw said, 'They have great respect in helping' to retain a degree of dignity. All greatly appreciated.' Another comment stated, 'Come on in leaps and bounds.'

One relative said, 'I always see a consistent group of carers, I have no issues at all.' Someone else said, 'We are lucky to have them.'

Staff told us that they encouraged people to do things for themselves but they made sure people were safe and provided them with timely assistance whenever that was appropriate. People were offered support at a level which encouraged independence and ensured their individual needs were met.

We saw that staff had signed a dignity charter which meant that the provider expected them to adhere to certain standards when providing care and support to people. This included when staff assisted people with personal care, such as toileting or bathing, they made sure doors were closed to protect people's dignity and privacy. We were told that people were addressed by their preferred name and saw that this had been part of the initial assessment prior to care being commenced.

Is the service responsive to people's needs?

People told us that if they needed the staff to do anything different or arrive at a different time the service were responsive to their request. People also said that they could guarantee the staff would arrive when expected. We saw that there was enough staff on duty to meet people's nursing and personal care needs. This was also confirmed by the four staff, and four relatives we spoke with.

All the staff we spoke with had a good understanding of how to support people in a way that respected each person as an individual, each with their own needs and preferences for how they wished to receive their care and support.

Is the service well-led?

There was a registered manager in post at the time of our inspection. Staff were aware of their roles and responsibilities and were supported effectively by the manager and provider. One staff member said, 'There is a good relationship between us all.'

The provider sought the views of people using the service and their representatives, and took account of these to make improvements. We found that there were effective systems to assess and monitor the quality of the service they provided and as a result they had identified concerns with the service in a timely fashion.

Staff said they received a good level of practical day-to-day support to enable them to carry out their duties. The provider had ensured there were robust quality assurance processes in place. This meant that people were assured of receiving the care they needed in a way that suited them.

The staff we spoke with told us said that the manager and provider had an 'open door' approach so that staff could readily express any concerns or ask for guidance whenever they needed to.