Eleanor Nursing and Social Care Ltd – Dorchester Office received an overall Good rating following a focused inspection triggered by a severe staffing crisis that caused missed visits and significant instability, resulting in a Requires Improvement rating for Well-Led. Robust remedial action by a new senior team, close partnership with the local authority, and stabilised staffing brought the Safe rating to Good, though governance, record-keeping, and person-centred engagement require ongoing improvement.
Concerns (8)
criticalMissed or late visits: “During the weeks immediately following this significant event there were not enough staff to meet people's needs and care visits were missed.”
criticalStaffing levels: “A large proportion of staff, including the registered manager and staff responsible for coordinating people's care, had left the organisation.”
moderateGovernance: “Work to transfer people's care documentation to the provider's new system had not happened effectively...new managers were not always accessing the most up to date information easily.”
moderateLeadership: “A temporary manager had been put in post...then a permanent manager was appointed who did not stay in post. A new manager had been appointed the week before the inspection.”
moderateRecord keeping: “Care documentation was not always detailed...these omissions increased the risk of errors being made by staff.”
moderateCare planning: “The transfer to the new electronic record had not been clear for a person and this meant their medicines had not been checked.”
moderateCommunication with families: “People and relatives were unsettled by this change and we heard numerous comments such as 'I have no idea who the manager is, I have heard lots of changes.'”
minorPerson-centred care: “One person told us, 'I have never been asked for feedback from old or new management.'”
Strengths
· Provider worked proactively with the local authority to manage the staffing crisis and reduce risks to people.
· Provider kept CQC informed throughout, with transparent communication about actions taken and their impact.
· Staff received safeguarding training and demonstrated confidence in recognising and reporting concerns.
· Medicines administration training and competency assessments were in place; senior team audited medicines promptly.
· Staff understood infection prevention and control procedures, including appropriate use of PPE.
Quality-Statement breakdown (10)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Working in partnership with othersGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringRequires improvement