We conducted an inspection of Eleanor Nursing & Social Care Ltd - Lewisham Office on 16, 19 and 20 November 2018. This was our first inspection of this service.

This service is a domiciliary care agency. It provides personal care for people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection they were supporting 420 people. Not everyone using Eleanor Nursing & Social Care Ltd - Lewisham Office receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager at the service. 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.

People were given appropriate support with their physical healthcare needs, but care records did not contain enough information about people’s mental health histories where there had been issues in the past.

Risk assessments identified risks to people’s care and contained clear guidelines to care staff about how they were required to mitigate these. However, care records did not contain enough information for care staff where risks had been identified in relation to their nutritional intake.

The provider was not consistently meeting the requirements of the Mental Capacity Act 2005 (MCA) as care records did not always contain clear details about people’s capacity and were sometimes signed by people’s next of kin without clear evidence that they were authorised to do so.

The provider assessed the quality of the service, but these checks did not identify the issues we found in relation to people’s mental health records and ensuring their care was delivered in line with their valid consent.

The provider had suitable safeguarding systems in place for the prevention of abuse. Care staff had received safeguarding training and understood the usual signs of abuse and what to do if these occurred.

Recruitment procedures helped ensure candidates were safe to work with people. The provider conducted appropriate pre- employment checks to assess candidate’s suitability for employment within the service.

Medicines were managed safely and people received support with their medicines where needed. The provider conducted checks of medicines administration and took action to rectify issues where needed.

Care workers received an appropriate induction and ongoing training, supervisions and appraisals of their performance.

Care staff had a good understanding about people’s preferences in the way they wanted their care delivered. Care staff supported people to be as independent as they wanted to be.

Care workers ensured that people's privacy and dignity was respected and promoted.

The provider had an effective complaints procedure and people told us they would raise a complaint if needed.

The provider met the Accessible Communications Standard and communicated with people in person and in writing in a manner that suited their needs.