ECL North Essex

At the last inspection on the 7 and 12 of October 2016 we asked the provider to make improvements because the service did not always assess and record risks correctly and did not always identify errors or omissions in medicines promptly. We also found that care plans were task focussed and lacked detail.

During this inspection, we found that the provider had improved the running of the service. There were elements of the service that were outstanding. We found that the service was "Outstanding" in the Well-led domain this was because the provider had plans in place to ensure that they continuously learnt and improved. The service provided a service based on core values that were visible at all levels of staffing. This meant that they had created a firm foundation to work towards providing an outstanding services in all areas.

People were receiving care from staff that had an excellent understanding of individual risks and needs. Staff had been thoroughly vetted and were employed because of their personal values as well as their skills. Staff were supported to develop their skills and knowledge and their understanding of safeguarding vulnerable people was excellent.

Systems were in place so people could take their prescribed medicines safely and people told us they were satisfied with the service being offered to them but some people told us that sometimes their visit times could vary. There were sufficient staff to meet people's needs and to manage risk.

The registered manager had good links with other health professionals within hospital and social care settings, working together to source the best care options for people referred to the service. Staff had access to a physiotherapist and occupational therapist who were on hand to offer advice and support regarding people's changing physical needs and equipment needs.

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.

Staff knew people well and had time to develop positive relationships with them. People were supported to consume food and drink of their choice and staff worked well with people and health care professionals, to ensure people maximised their health and wellbeing. People received support that was personalised and staff responded flexibly to changes in their lives.

Guidance was in place to enable staff to provide a consistent level of support. We have made a recommendation about end of life care. People and their relatives told us they were aware of how to make a complaint and felt they were listened to by the registered manager.

People told us that staff were kind and compassionate and spoke highly of them. Staff promoted person centred care at all levels of seniority to ensure the best outcomes for people. People told us that they were treated in a respectful and dignified way at all times.

The five questions we ask about services and what we found