Elite Homecarers - Care at Home Support Service Care at Home 25B High Street South Queensferry EH30 9HW Telephone:

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1 Elite Homecarers - Care at Home Support Service Care at Home 25B High Street South Queensferry EH30 9HW Telephone: Inspected by: Stephen Ball Type of inspection: Unannounced Inspection completed on: 21 January 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 12 4 Other information 24 5 Summary of grades 25 6 Inspection and grading history 25 Service provided by: C & D DH Ltd Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Stephen Ball Telephone Elite Homecarers - Care at Home, page 2 of 27

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well The service users we met with told us that they were happy with the service provided by Elite Home Carers. Where issues had been raised, those we spoke with felt the service had worked with them to resolve any issues quickly. What the service could do better The service would benefit from introducing a system of recording dates and timelines on relevant documents contained in both staff and service user files. An audit trail of this kind would provide clarity on the documents in place and allow for the system to identify when documents need to be reviewed and updated. We have highlighted this further in our report. What the service has done since the last inspection The service has introduced an electronic staff monitoring system in conjunction with a local authority. This allows the management of the service to ensure staff attend to their visits with service users in a timely fashion and any late or missed visits are very quickly identified and addressed. We were provided with a demonstration of the staff monitoring system at the time of our inspection. Conclusion We feel the service has continued to develop in some areas since our last inspection. However there remains some areas where improvement is required. This is namely in Elite Homecarers - Care at Home, page 3 of 27

4 relation to files being more organised and accessible and to implement file audit systems. Who did this inspection Stephen Ball Elite Homecarers - Care at Home, page 4 of 27

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Requirements and recommendations If we are concerned about some aspect of a service, or think it needs to do more to improve, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service based on best practice or the National Care Standards. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 ("the Act") and secondary legislation made under the Act, or a condition of registration. Where there are breaches of Regulations, Orders or conditions, a requirement may be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. ABOUT THE SERVICE WE INSPECTED Elite Home Carers provide support to a wide range of people with varying needs aged 18 years and over to assist them live independently in their own homes. The service is provided to approximately 130 service users assisting them with personal care and a variety of domestic tasks such as housework and shopping. The service is available 24 hours a day, seven days a week. The service aims to "enhance the lives of clients and their loved ones" and be "an emergency 24-hour on-call service that ensures that clients have peace of mind and are reassured that support is available when they really need it." Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 4 - Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Elite Homecarers - Care at Home, page 5 of 27

6 Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Elite Homecarers - Care at Home, page 6 of 27

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report following an unannounced inspection. The inspection was carried out by Care Inspectorate Inspector Stephen Ball. As requested by us the care service sent us an annual return. The service also completed a self assessment form. In this inspection we gathered evidence from various sources including the relevant sections of policies, procedures and other documents including: * Sampled 15 care and support plans * Sampled 15 review documents of care and support plans * Looked at service user care and Support agreements * Read a sample of staff team meeting minutes * Reviewed a sample of incident reports * Read any complaints received since the last inspection and what actions the service had taken following the outcome of them. * Quality assurance information * Met with the registered manager of the service * The inspector visited seven service users at their homes, held face to face discussions and undertook audits of the care and support documents. * Met with eight support staff and spoke with them with regards to their ongoing training and support from senior management. * Collated the responses from questionnaires issued to service users, carers and relatives. * Sampled the evidence detailed within the self assessment document the service completed prior to our inspection. *Spoke with stakeholders. Two occupational therapists and one social worker. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality Elite Homecarers - Care at Home, page 7 of 27

8 themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at Elite Homecarers - Care at Home, page 8 of 27

9 What the service has done to meet any requirements we made at our last inspection The requirement This is a requirement from the last inspection by the Care Commission which was carried out between September 2010 and January 2011 which is detailed in the Inspection Report of 2nd March The provider must ensure that there is adequate supervision and support to staff in the ongoing scheduling and delivery of care to ensure that service users receive the time allocated in full to meet their care needs. This should include an audit of all records and appropriate action organised, including training where necessary. This is in order to comply with SSI 2002 No 114, Regulation 4(1)(a) - Health and welfare of service users; 5 - Personal plans; 13 - Staffing. What the service did to meet the requirement The service has implemented an electronic monitoring system which monitors the location of staff at any given time. This system allows for any late or missed visits to be very quickly identified and addressed by the management of the service. This system is available in Edinburgh and being rolled out in other areas very shortly. The requirement is: Met The requirement The provider must ensure that there is adequate supervision and support to staff and this be evidenced in staff files. This is in order to comply with SSI 2002 No 114, Regulation 4(1)(a) - Health and welfare of service users; 5 - Personal plans; 13 - Staffing What the service did to meet the requirement We identified that staff are receiving support and supervision meetings with their line managers, however these meetings are not being undertaken on a regular basis and in line with the service's procedure. We have therefore made a recommendation within this report that the meetings are undertaken in line with their procedure. The requirement is: Met Elite Homecarers - Care at Home, page 9 of 27

10 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Inspection report continued Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of the headings that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they planned. Taking the views of people using the care service into account We sent out 60 CI Care Standard Questionnaires to people using the service, relatives and carers. 33 were returned to us. Feedback from service users Positive comments received "My support workers are very friendly and most helpful. I am really happy." "The carer is excellent and friendly." Some raised particular issues: "I feel the staff do not have enough time to carry out all of their duties whilst here, they are in a rush." One service user told us that they felt the service provider did not always have enough time to carry out the agreed care and support. 11 service users did not know how to make a complaint to the service provider 12 service users told us that they did not know the procedure for making a complaint to the Care Inspectorate. Elite Homecarers - Care at Home, page 10 of 27

11 Taking account of staff members Staff questionnaires were issued, 14 were returned to us. Positives The majority of the responses received were positive. Some raised particular issues: "...the communication from HQ to staff could be improved and travel time in between clients is not taken into consideration when scheduling (visits)." Taking carers' views into account Positive comments made included: " XXX is happy with the carers and the care provided (to him). Any problems or requests are always dealt with." Elite Homecarers - Care at Home, page 11 of 27

12 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths Elite Home Carers provides service users and their relatives with welcome packs which fully detail the aims and objectives of the service and the standards expected of their delivery. It also provides guidance on making a complaint and contact details of local advocacy support agencies should a service user wish to have external support in making a complaint. The service also has a document it shares with service users and their families called a service user participation strategy. This document details how the service provider promotes service user involvement in the continued assessment and improvement of the service they receive. It includes some of the tools and methods used to achieve this. For example; annual service user questionnaires, service user involvement in support staff recruitment, training and staff appraisals. We sampled the service user questionnaire process undertaken in The questions focused on gathering the service user's views on the flexibility of the service, staff attitudes, communication and reliability of the service. It also covered asking whether the support staff had the necessary skills and experience for meeting the needs of service uses and whether the staffing was consistent. The majority of the responses were very good. We read through any complaints the service had received since we last inspected the service. 3 complaints had been received and we found that the service had followed their procedures in addressing the complaints received. Action plans of further improvement had also been implemented for the complaints which had been upheld by the service provider. Elite Homecarers - Care at Home, page 12 of 27

13 The service also has a system in place for service users and their relatives to raise a concern with the service. There are then logged and addressed by service management. Raising a concern in this way is a method of allowing service users to make an informal complaint to the service. We read a sample of the many thank you cards which the service has received from service users and their families over the years. Areas for improvement We sent out 60 pre-inspection questionnaires to service users to gather their views of the service they receive from Elite. 11 service users told us that they did not know how to make a complaint to the service and 12 users told us they did not know how to make a complaint to the Care Inspectorate. We are aware having read the improvement plan for 2012 / 2013 the service has written prior to our inspection that they intend to review the information provided on the complaints procedure. The service provider plans to produce leaflets and other methods of communicating the information to service users and their relatives. We are making a recommendation that the service provider follows through with their action plan to implement the improvements already identified. Please see recommendation 1. Although the responses from the annual service user satisfaction questionnaires were positive, the service should implement an action plan based on the findings received. This would strengthen the opportunities for service users to have a direct influence on the assessment and improvement of the service provided. We also identified that although newsletters are in place for staff, they are yet to be implemented for service users. Providing newsletters to service users would be an essential tool to use to provide feedback to people who use the service and have contributed suggestions of how the service could be improved. We are therefore making this a recommendation. Please see recommendation 2. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 2 Recommendations 1. The service provider should implement the actions already identified and highlighted within their development plan in relation to information to service users and carers on the complaints procedures. National Care Standards, Care at Home, Standard 11 - Expressing your views. Elite Homecarers - Care at Home, page 13 of 27

14 2. The service provider should provide a means of providing feedback to service users following their involvement in assessing and improving the quality of the service provided. National Care Standards, Care at Home, Standard 11 - Expressing your views Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We sampled 15 service users' files to examine relevant documents, for example the service user care plans which details their care and support needs requirements. We also looked at support files held within the homes of seven service users. The care plans we sampled were very detailed and were outcome focused, meaning all service users have active goals they would like to achieve with the support from the care staff. We found this to be a consistent approach for all those we sampled. Along with the assessment of care and support needs undertaken, we found the care plans provided good detail to support staff on the support tasks to be provided and how they should be delivered. This level of detail should support the process of ensuring a great deal of consistency from support staff is provided. The care plans also included information on other care providers which we saw to be good practice in holding relevant documentation on the support individuals receive overall. We also saw good evidence of the service provider working with external agencies like the social work department and community nurses to strive to ensure service users support needs are being met. Whilst sampling the care plans, we also looked at the risk assessments completed for service users. Again we found these to be detailed in the findings of the assessments undertaken. For example; an assessment of service user's physical and mental health, their comprehension, communication levels, behavioural issues, their mobility, and any history of falls. In addition to the risk assessments, safety assessments are also undertaken on the homes of service users. These focus on the following areas: exit doors are kept clear from obstruction, smoke detectors are fitted and the safe storage of flammable liquids. We read a number of policies and procedures the service operates to, to ensure these are up to date to meet current legislation requirements and best practice. These included the following: infection control, medication, incident reporting, moving and Elite Homecarers - Care at Home, page 14 of 27

15 handing, health and safety and whistle blowing. Our assessment of these documents were to go a good standard. The service also has a detailed adult support and protection policy and procedure. This document details examples of abuse and the different forms of abuse. Clear procedures on how staff should report any concerns were also included within the document. The staff we met with were familiar with how to operate these procedures. The service users we met with told us that the provision of care was consistent, in that it was the same support staff who catered to their support needs. We saw this to be a strength for this service. When we visited the offices of Elite Home Carers, we were provided with a demonstration of the staff electronic monitoring system which is in place, provided in conjunction with Edinburgh City Council. This is a system which electronically monitors the attendance of support staff visiting the homes of service users. Staff use a free phone service to alert the system of their arrival and departure from a visit. We found this to be a good process for service management to monitor the service delivery. The service users we met with told us that they felt very supported by the care staff and the staff were the same faces supporting them, bringing consistency to service delivery. As part of the inspection process, we spoke with one social worker and two occupational therapists who have regular contact with Elite Home Carers though their day to day work. The majority of the feedback from those we spoke with was very positive and they had a high regard for the support that is provided to service users. Areas for improvement Inspection report continued When we sampled the reviews of care plans undertaken to ensure regular reviews of care needs of individuals are being reviewed, we found there to be a lack of reviews being evidenced. Where reviews had been held, we did not see a great deal of service user involvement in the review process. The service provider must ensure that reviews of care and support needs are undertaken with the service user on a six monthly basis, or more frequent if any changes are identified. We are therefore making this a requirement. Please see requirement 1. Although our assessment of the contents of the care plans were good, we felt the structure of the service user files and documents needs to be reviewed. When sampling the documents, it was difficult for us to make an informed assessment of the timelines involved in when care plans are implemented and the reviews of these care plans have been undertaken. The service should implement a file auditing Elite Homecarers - Care at Home, page 15 of 27

16 system to allow for the timelines of care plans and reviews of plans to be more transparent. We are therefore making this a recommendation. Please see recommendation 1. When reviewing the structure of the service user files, the care plan document should be updated to include a section within the pro-forma used for the service user to sign and confirm their agreement of the support to be provided. (We are linking this recommendation to recommendation 1). Whilst we found the contents of risk assessments to be of a good standard, we felt they lacked guidance for staff in how to support service users to minimise and manage the identified risks. For example, one risk assessment detailed that the service user is verbally aggressive and unpredictable in his behaviour but did not include guidance for staff in supporting this individual. The service provider should review these documents to ensure information is provided to staff on the management of the risks. We are therefore making this a recommendation. Please see recommendation 2. We also identified through our sampling of documents that four of the risk assessments had not been reviewed in the past six months, which is a requirement under legislation. We also saw nine risk assessments which were not dated so could not make an assessment of when these were undertaken. one risk assessment form for a service user had not been completed. The service provider must ensure that all service users are risk assessed as part of their support package and are reviewed on a six monthly basis. We are therefore making this a requirement. Please see requirement 2. On reading the relevant policies and procedures which the service operates to, we found that the adult support and protection policy should be reviewed to include contact details of local external agencies, for example the police and social work departments. We are therefore making this a recommendation. Please see recommendation 3. One of the occupational therapists (OT) we spoke with advised us of a current service user who would like their care and support provided in a certain way, which fulfills their personal needs and choice. We were told by the OT that the service user's care and support needs were not being provided in the preferred and consistent manner voiced by the service user concerned. We spoke with the service provider with regards to this matter and we were advised by the manager that communication is ongoing with the service user and the OT concerned. Given that communication is ongoing between the service user, the service provider and the OT at the time of our inspection with regards to addressing this, we are making the recommendation that a review of the service users care needs is undertaken as a matter of priority. This would allow for an up to date assessment of needs to be undertaken to ensure the needs of the service user are being fully met. Please see recommendation 4. Elite Homecarers - Care at Home, page 16 of 27

17 Grade awarded for this statement: 4 - Good Number of requirements: 2 Number of recommendations: 3 Requirements 1. The service provider must ensure that reviews of care and support plans are undertaken on a 6 monthly basis or less if required. This is to comply with the Scottish Statutory Instruments (SSI) 2011 No 210, Personal Plans (5.2b,c,d) Timescale: Within an 8 week period on receipt of this report. 2. The service provider must ensure risk assessments are undertaken for all service users and reviewed on a 6-monthly basis or less as and when required. This is to comply with the Scottish Statutory Instruments (SSI) 2011 No 210, Welfare of users, (4.1a) make proper provision for the health, welfare and safety of service users Timescale: Within 28 days on receipt of this report. Recommendations 1. The service should implement a file auditing system to allow for the timelines of care plans and reviews of plans to be more transparent. National Care Standards, Care at Home, Standard 4 - Management & Staffing. 2. The service provider should implement guidance for support staff in following the risk management procedures to meet the needs of the service users. National Care Standards, Care at Home, Standard 4 - Management & Staffing. 3. The service provider should ensure that their Adult support and protection policy includes a detailed step by step procedure for staff to follow when concerns are identified. The document should also include contact information on local external agencies, for example the police and social work departments. National Care Standards, Care at Home, Standard 4, Staffing and management. 4. The service provider should undertake a review and assessment of needs for the individual concerned to ensure their care and support needs are being fully met. National Care Standards - Care at Home, Care at Home, Inspection report continued Elite Homecarers - Care at Home, page 17 of 27

18 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths Statement 1.1 has also been taken into account for this statement. The service has in place a variety of quality assurance processes in place. We sampled the quality assurance visits which are undertaken with service users on a regular basis. This involves a joint meeting between service user, support worker and their line manager and various quality assurance questions are asked of the service user. These include; Whether the staff member wears ID at all times, show respect and dignity at all times, staff have the relevant training and experience to fulfil the needs of the service users and whether the staff are consistent. All parties sign the quality assurance visit pro-forma and any concerns highlighted are quickly addressed. The feedback obtained on staff performance is also fed into the staff members annual appraisals. We saw this to be good practice in involving service users in assessing and improving the quality of staffing within the service. Areas for improvement Statement 1.1 has also been taken into account for this statement. An area the service provider could develop on for this statement is to involve service users in the recruitment of staff. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We are confident that our staff have been recruited, and inducted, in a safe and robust manner to protect service users and staff. Elite Homecarers - Care at Home, page 18 of 27

19 Service strengths As part of this inspection, we completed a check of staff files to ensure safer recruitment practise had been undertaken in line with the service's policy and procedure. We sampled eight staff files to check that the procedures had been followed correctly. Of the eight we sampled, all had correct documentation present in terms of adhering to their safer recruitment policies. We found that good pre-employment checks are undertaken. This included preemployment checks on two previous employment references, copies of any relevant qualifications, criminal checks and health questionnaires. All safer recruitment documents are also scanned onto an IT system for safe keeping too. Areas for improvement The service would benefit with improving the file audits in place to ensure all the information on safer recruitment is kept in one location for easy access and assessment. Please see recommendation 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service provider should improve the file audits in place for safer recruitment to allow easy access and assessment of information. National Care Standards, Care at Home, Standard 4 - Staffing and Management. Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued We read the various policies and procedures in relation to staff being inducted, training and supported within their roles as support workers. The support staff are provided an induction programme which consists of two days of learning the various policies and procedures, followed by a period of shadowing more experienced staff. We sampled the induction records which showed us that staff had received a full induction. The training also covered; the National Care Standards, promoting independence, maintaining professional boundaries, whistle blowing, Elite Homecarers - Care at Home, page 19 of 27

20 medication, catheter and stoma care, peg feeding, bathing and adult support and protection. Those we met with were familiar with how to operate to these procedures. We saw evidence of staff receiving ongoing training in the above areas. Elite Home Carers has a staff support and supervision policy in place. This document details the aims and objectives of staff receiving monthly meetings with their line managers to review their current work performance. We read the findings report from the staff questionnaire which was undertaken in July We saw that the majority of the responses to the management of the service we positive. The staff we spoke with told us that they felt very supported by the management of the service. Areas for improvement Inspection report continued When we reviewed the responses from our pre-inspection questionnaires, three staff members told us that they felt the communication from senior management could be improved. We discussed our findings with the service manager. We identified when reading the staff meeting notes that these meetings are not held on a regular basis. According to the evidence we saw, only three meetings were held in Newsletters are provided to staff on a regular basis to update the staff on service developments and any changes in policies and procedures. Although this is a method of communicating with staff, the service should review how often the staff meetings are held. We discussed our findings with the service manager who advised that localised team meetings are held. However we did not see any evidence of this. We are therefore making a recommendation that the service provider hold regular staff meetings as an effective method of communicating important service information to staff and to involve them in any discussions about the development of the service. Please see recommendation 1. Although the staff questionnaires issued by the service provider in 2012 received may positive responses, the service would benefit from implementing an action plan of further improvement based on the feedback given by the staff. We are therefore making this a recommendation. Please see recommendation 2. We sampled eight staff support and supervision meeting notes and identified gaps in the frequency of when these meetings are held and this was not in line with the service provider's policy as detailed above. The service provider should provide monthly support and supervision meetings with their workforce n line with their procedure. We are therefore making this a recommendation. Please see Elite Homecarers - Care at Home, page 20 of 27

21 recommendation 3. We were advised by the registered manager of the service that staff appraisals were yet to be introduced and are on the current action plan the service is working towards. We will therefore follow this up at our next inspection. An SVQ programme is in place to ensure the workforce of Elite Home Carers are adequately qualified for their role. Out of the 85 staff employed at the time of this inspection, 18 have the relevant qualifications and 6 are studying. The main qualification that staff are studying for is the SVQ 2 in Health and Social Care. The service provider should ensure that it continues to implement the appropriate training and qualifications to fulfil the Scottish Social Services Council (SSSC) requirements by their timescales. We will follow this up at our next inspection of the service. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 3 Recommendations 1. The service provider should ensure that staff meetings are held on a regular basis to be able to share work related practice and service development. National Care Standards, Care at Home, Standard 4 - Staffing and management. 2. The service provider should implement action plans of further improvement and development following consultation with support staff. National Care Standards, Care at Home, Standard 4 - Staffing and Management. 3. The service provider should ensure that regular support and supervision meetings are undertaken in line with the service's policies and procedures. National Care Standards, Care at Home, Standard 4 - Staffing and Management. Elite Homecarers - Care at Home, page 21 of 27

22 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths Statements 1.1 and 3.1 have been taken into account for this statement. Areas for improvement Statements 1.1 and 3.1 have been taken into account for this statement. The service would benefit with increasing the opportunities for service users and their carers to assess and improve the quality of management and leadership within the service. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths Elite Home Carers has a quality assurance policy in place. This document details the approaches the organisation takes to assess and improve the quality of the service provided. The approaches adopted include; regular quality performance checks with service users (as detailed in Statement 3.1), assessing whether the staff are polite, respectful and have the relevant skills and experience for the role they undertake. The policy also states that spot checks on quality are undertaken by the service manager on a regular basis. Elite Homecarers - Care at Home, page 22 of 27

23 We read the service's continued improvement and development action which is in place. This includes developing service user forums and the information provided to service users on the complaints procedure. When we met with the service manager, we were shown evidence of where Elite Home Carers rank compared with other service providers in relation to support staff arriving on time to their visits and providing a consistent service. The evidence we saw showed us that the service was performing well and was improving. Areas for improvement The service should introduce a clear system of recording dates and timelines on relevant documents contained in both staff and service user files. An audit trail of this kind would provide clarity on the documents in place and allow for the system to identify when documents need to be reviewed and updated. The service provider should review the current service user file structures in place and introduce file audits. This would then provide clarity of the timelines involved in care plans and reviews undertaken. We have made recommendations in relation to this earlier in this inspection report under statements 1.3 and 3.2. The service provider should continue to implement quality assurance systems to continue to develop the service within this quality statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Elite Homecarers - Care at Home, page 23 of 27

24 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Elite Homecarers - Care at Home, page 24 of 27

25 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Very Good 4 - Good Quality of Staffing Good Statement 1 Statement 2 Statement Very Good 5 - Very Good 4 - Good Quality of Management and Leadership Good Statement 1 Statement Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 30 Nov 2011 Unannounced Care and support 4 - Good Staffing 4 - Good Management and Leadership 4 - Good 2 Mar 2011 Announced Care and support 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate 22 Jan 2010 Announced Care and support 4 - Good Staffing 3 - Adequate Management and Leadership 4 - Good 9 Jan 2009 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 4 - Good Elite Homecarers - Care at Home, page 25 of 27

26 All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Elite Homecarers - Care at Home, page 26 of 27

27 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: Web: Elite Homecarers - Care at Home, page 27 of 27

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