Archived: Allround Nursing Care Limited

During our inspection we wanted to understand people's experience of the service they were using. We did this by talking with people, their relatives and checking how staff responded to them, reading care records about their care and speaking with staff about people's needs.

Our inspection was announced and in response to concerns raised in July 2014. Concerns were raised about staff not wearing appropriate protective clothing when working in people's homes. We were informed there were no care plans to guide staff. We were told people's safety was at risk because effective recruitment and selection procedures were not being followed. We were told staff worked excessive hours to provide cover. We visited this service on 28 July 2014 to follow up on concerns raised about people's safety.

The evidence we collected helped us to answer five key questions.

Below is a summary of what we found.

Is the service safe?

We saw that people's consent to care and treatment was obtained. We also saw that if people were unable to make decisions for themselves, for example due to dementia, that appropriate procedures were being used to obtain and record consent for their care.

We found that systems for care planning and risk assessments were followed.

One family representative told us, 'I can have some respite time because I feel comfortable leaving my relative alone with staff.' People using services, and their family representatives, told us they felt safe with staff from the agency.

We found the care provided was consistent and safe levels of support were delivered to meet people's needs. Staff who spoke with us confirmed they wore protective clothing and were supplied with disposable aprons and gloves when providing care. This meant they were able to reduce the likelihood of cross infection between the people they visited.

At the time of our inspection staff were being recruited and sufficient numbers of staff were available to meet people's needs. We found safe recruitment procedures were in place to protect people from harm.

Is the service effective?

Care plans and daily records identified how people were helped to maintain good health and receive on going health care support. Staff who supported people were provided with the knowledge and skills necessary to carry out their roles and responsibilities.

Is the service caring?

Family representatives who spoke with us told staff had developed caring and positive relationships with people using the service. People's privacy and dignity needs were respected and promoted. Care that was centred on people's individual needs was provided to them. Staff told us that they had a good rapport with people using the service and understood how to help people in the way they preferred.

Is the service responsive?

People and their family representatives told us they were listened to and supported. This meant that they were actively involved in care that was personalised and responsive to their needs. To ensure people's safety and welfare staff received guidance to help support people in the way they preferred to be assisted. One relative told us the agency was temporarily short of staff. The manager herself provided the extra cover. This meant people using the service were able to have their needs met.

Is the service well led?

A family member told us, 'The manager of the service is part of the team and is always available to us. I am reassured by this. It is a good agency because it focusses on my relative's needs. All the staff are good I cannot fault them.'

The manager was in daily charge of the service. They also provided care and regularly received direct feedback from people using the service, and their relatives. This meant they could assess how the service was meeting people's needs.

The support was provided by staff who knew the needs of people well and what to do to assist them. People said they had no concerns about the service and knew how to raise concerns should they need to.

People we spoke with told us their relatives received the care, treatment and support that met their individual needs. They confirmed people were relaxed and comfortable with staff, who were respectful and provided positive support. One relative told us, 'My mum would be lost without them. She knows who they are and I've seen them in action; they're just marvellous.'

Staff respected people's decisions and understood their responsibilities with regards the daily support. Systems were not in place to gain consent for care and treatment from people who using the service who did not have capacity.

The staff received training that was appropriate for their individual needs and provided them with the information they needed to care for the people living in their own home.

People were formally consulted about the care they received. Systems were not in place to demonstrate the provider could monitor and improve the quality of the care delivered.