ELMS Health Solution is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At this inspection it provided the regulated activity of personal care and support to five adults. The service also provided live-in care workers. This meant that there was a care worker present 24 hours’ a day, seven days a week.

This inspection took place on 17 and 18 January 2019. The inspection was announced. This is the first Care Quality Commission (CQC) inspection since the service registered on 22 January 2018.

Not everyone using ELMS Health Solution received 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 in place. 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.

Trained staff prompted people to take their prescribed medicines. However, people’s medicines’ administration records lacked guidance for staff on whose responsibility it was to order, collect and dispose of people’s medicines. This increased the risk of people missing their regular prescription.

Staff understood their duty to report concerns to protect people from the risk of poor care and harm. People had risk management plans to provide guidance and information for staff on how to reduce and monitor assessed risks to their health and welfare. However, although staff knew people’s risks and care support needs, people’s documented risk assessments and care plans were not always up-to-date. Within the office, people’s care records were held securely to ensure confidentiality.

Staff had recruitment checks completed on them prior to starting work at the service. However additional checks carried out to ensure a potential new staff members suitability were not always documented.

The registered manager responded to concerns and resolved these where possible. The registered manager led by example and encouraged an open and honest culture within their staff team. Audit and governance systems were in place so that they could drive forward any improvements required. However, we found that this oversight was not always as effective as it could have been. This is because areas found during this inspection requiring improvement, had not been identified. The registered manager and their staff team linked up and worked with other organisations to ensure people’s well-being.

One notifiable incident had not been sent to the CQC promptly. The registered manager put actions in place to improve this for any further such occurrences. A notification is information about important events that the law requires the provider to notify us about such as safeguarding concerns, deaths, and serious incidents.

People’s care was consistently provided at a time and duration they expected. Staff treated people with compassion and kindness. Staff maintained people’s privacy and dignity when supporting them with their personal care. Staff helped people, where needed, with their eating and drinking to promote well-being.

People had technology and equipment in place to help staff assist them to receive safe care and support. The registered manager, when things did not go as planned, took actions to prevent these events from happening again.

Staff had training to meet people’s care and support needs. To develop staff, supervisions and competency ‘spot checks’ were in place.

Staff maintained good infection prevention and control practices when supporting people including wearing personal protective equipment such as aprons and gloves.

People and