Elderflower Homecare

We inspected the service on 10, 15 and 17 May 2018. We gave 48 hours' notice of our inspection as we needed to be sure somebody would be in the office.

There was a registered manager in post who was also the owner of the company.

Checks to monitor the safety and quality of the service had been carried out. Whilst these checks highlighted and addressed some issues they had not consistently noted and addressed the issues we found with documentation during our inspection.

People who used the service told us they felt safe. Staff received safeguarding training and understood the signs of abuse and how to report any concerns. Overall people received support with their medicines as needed, although protocols to describe when 'as and when needed' medicines were required were not always in place. Risk assessments were completed however they were not always updated when people's needs changed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Capacity assessments had not always been completed when there were concerns about a person's ability to understand and consent to the way support was provided. The registered manager agreed to ensure these were completed. Staff sought people's consent and promoted their choice. The staff maintained contact with healthcare professionals and sought their input and guidance when needed. The staff team were supported through one to one supervisions and an annual appraisal of their performance.

Without exception, we received positive feedback from people and their families about the staff team. They were described as kind and caring and that they had built good relationships with the people they supported. People's dignity was upheld and staff treated them with respect. Information about advocacy support was available when needed.

People received support in accordance with their individual needs and their needs, likes and preferences were recorded. People received support to attend activities of their choosing. People received end of life support and staff responded to their changing needs. However, end of life care plans were not in place for staff to understand people's preferences and wishes.

Staff attended team meetings which were an opportunity for further learning. The registered manager and

management team were keen to ensure their knowledge was up-to-date and maintained links with community organisations. The registered manager sought people's views on the support and organisation by way of a feedback form. The feedback provided was positive.

Further information is in the detailed findings below.

The five questions we ask about services and what we found