We undertook this announced inspection on 8 February 2019. Elite Specialist Care Limited is registered to provide Personal Care services to people in their own homes. The services they provide include personal care, housework and support with medicines. The service re-registered with us in April 2016 following their relocation to new premises. At the time of this inspection, the registered manager informed us that there were four people who used the service requiring personal care. The service also provided care workers who supported staff from hospices caring for people requiring palliative care in their own homes. This aspect of the service was short term and care workers worked in accordance with the care plans prepared by hospice staff. People who used the service mainly lived in the Westminster, Brent and Harrow.

Not everyone using Elite Specialist Care Limited receives a regulated activity; CQC only inspects the service 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.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

At the last comprehensive inspection we carried out on 27 July 2016 the service was rated Good. We however, found a breach of Regulation 17 Good Governance. The service did not have a system of regular and comprehensive quality audits and checks for monitoring and improving the quality of the service. This may affect the safety and quality of care provided for people. At our responsive inspection on 23 March 2017 we found the service had complied with the requirement made. There were comprehensive audits and checks for monitoring and improving the quality of the service. At this inspection on 8 February 2019, we found some deficiencies related to Safe and Well Led. We have therefore rated the service as Requires Improvement.

People and their representatives informed us that they were satisfied with the care and services provided. They informed us that people were treated with respect and they were safe when cared for by the service. There was a safeguarding adults’ policy and care workers were aware of action to take should they be aware that people were being abused. We however, noted that the safeguarding policy and procedure did not include reference to the role of the DBS.

This was completed during the inspection. The service had a policy for ensuring equality and valuing diversity. Care workers had a good understanding of equality and diversity (E & D) and protecting people’s human rights. They were aware of the importance of treating people as individuals and showing respect for them regardless of their background or individual circumstances.

People’s care needs and some potential risks to them were assessed and guidance provided to care workers on how to care for people. We however, noted that some risk assessments had not been documented for people who needed them. These are required to provide information for care workers and to ensure the safety and welfare of people.

The service had an infection control policy. However, it was not sufficiently comprehensive as it did not contain examples of infectious diseases.

Care workers prepared appropriate and up to date care plans which involved people and their representatives. The service worked well with healthcare professionals to ensure that people’s healthcare needs were monitored and attended to. There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Reviews of care had

We undertook this announced inspection on 23 March 2017. Elite Specialist Care Limited is registered to provide Personal Care services to people in their own homes. The services they provide include personal care, housework and assistance with medicines.

At our last comprehensive inspection on 27 July 2016 we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service did not have an effective system in place for auditing and checking the quality of the service. This may affect the safety and quality of care provided for people. After the comprehensive inspection, the registered provider sent us an action plan telling us how they would meet legal requirements. We undertook this focused inspection on the 23 March 2017 to check that they had followed their plan and to confirm they now met legal requirements in relation to good governance.

This report only covers our findings in relation to good governance. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Elite Specialist Care Limited’ on our website at www.cqc.org.uk’.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

At this focused inspection, we found that the provider taken action to comply with good governance. Audits of the service had been carried out by a director of the company. In addition, checks on the quality of care provided by the service had been carried out by the director and the registered manager. These included spot checks on care workers and reviews of the services provided.

A satisfaction survey had been carried out. People who used the service expressed confidence in the management of the service.

We undertook this announced inspection on 27 July 2016. Elite Specialist Care Limited is registered to provide Personal Care services to people in their own homes. The services they provide include personal care, housework and assistance with medicines. The service re-registered with us in March 2016 following their relocation to it's new premises. This is the first inspection of this service in their new location.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People and their representatives informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they were safe when cared for by the service. There was a safeguarding adults policy and suitable arrangements for safeguarding people from abuse.

Care workers were caring in their approach and knowledgeable regarding the individual choices and preferences of people. People’s care needs and potential risks to them were assessed and guidance provided to care workers on how to care for people. Care workers prepared appropriate and up to date care plans which involved people and their representatives. The service worked well with healthcare professionals to ensure that people’s healthcare needs were monitored and attended to. This was confirmed by professionals we contacted.

There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Reviews of care had been carried out to ensure that people received appropriate care. The service had a policy and procedure for the administration of medicines. However, we were informed that none of the people using the service needed assistance with their medicines.

Care workers had been carefully recruited. the necessary checks had been undertaken prior to them starting work. New care workers had been provided with a comprehensive induction and training programme to enable them to care effectively for people. They had the necessary support, supervision and appraisals from their managers. Teamwork and communication within the service was good.

People and their representatives expressed confidence in the management of the service. They stated that care workers communicated well with them and kept them informed if they were held up or running late. Care workers were aware of the values and aims of the service and this included treating people with respect and dignity, providing high quality care and promoting people’s independence where appropriate.

Complaints made had been promptly responded to. Two healthcare professionals provided positive feedback regarding the management of the service. They indicated that the service was well organised and there was good communication with the service regarding the progress of people.

The registered manager stated that checks of the service had been carried out regularly by their Field Supervisor. These included spot checks on care workers, reviews of care and risk assessments. Evidence of these were provided. We however, noted that there was no evidence of regular audits being carried out. There was no written evidence of regular audits in areas such as complaints, policies and procedures and punctuality of staff. Comprehensive audits are needed so that the service can identify and promptly rectify deficiencies.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.