Eskcare Limited, a domiciliary care agency in Carlisle, received an overall rating of Good at its first inspection in January 2023, with people reporting feeling safe and well-cared-for by trained, compassionate staff. The Well-Led domain was rated Requires Improvement due to audit systems failing to identify recording gaps across medicines, recruitment and consent records, though the registered manager acted promptly to address all issues raised during the inspection.
Concerns (6)
moderateRecord keeping: “The provider's audits and checks to monitor the quality and safety of the service did not always identify some recording shortfalls. These included some medicines, staff and consent records.”
moderateGovernance: “Some audits were not always effective as they had not identified some recording gaps such as medicines anomalies, recruitment records and communication needs.”
minorMedication management: “Medicine records were not always clear and did not follow the medicines policy. Recording issues were discussed with the registered manager and addressed immediately.”
minorConsent / capacity: “Some records did not record whether relatives had the legal status to make decisions on behalf of people if they lacked capacity.”
minorCommunication with families: “People's communication needs were not always clearly outlined in the care files and alternative methods of communication to support people were not always explored.”
minorStaff training: “A training matrix was in place to record and manage staff training although this was not effective at identifying future training needs.”
Strengths
· People reported feeling very safe and praised staff as caring, cheerful and respectful of their dignity and privacy.
· Risks were assessed with appropriate measures in place and staff were confident in reporting concerns to management.
· Staff were trained in medication management and safeguarding, with refresher training in place.
· Sufficient staffing levels were maintained with a system to arrange additional support during pressures.
· Effective infection control systems were in place with appropriate PPE provision and COVID-19 guidance.
Quality-Statement breakdown (25)
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Staff support: induction, training, skills and experienceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
responsive: Meeting people's communication needsRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood