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Archived: ANA Nursing

Overall: Good read more about inspection ratings

Middlesex House, 29-45 High Street, Edgware, Middlesex, HA8 7UU (020) 8905 7701

Provided and run by:
ANA Homecare Limited

Important: This service was previously registered at a different address - see old profile

All Inspections

7 December 2016

During a routine inspection

We undertook an announced inspection on 7 December 2016 of ANA Nursing. ANA Nursing is registered to provide the regulated activity personal care and provides personal care, housework and assistance with medicines in people’s homes.

At the time of the inspection, the service was providing care and supporting 22 people. There were 15 care workers. .

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection on 10 September 2015, the service did not meet Regulations 9, 10, 14, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found there were issues with care workers punctuality, there were instances in which people were not being treated with dignity and respect, care records were not person centred and auditing processes were not robust enough to monitor and improve the quality of the service. This meant the quality rating we awarded was requires improvement.

Following our September 2015 inspection we received an action plan from the service telling us what action they would take. At this inspection the registered manager was able to demonstrate that measures had been put in place since the last inspection to respond to the issues identified and meet regulations. People using the service and relatives also told us that they had found improvements had been made to the service they received since the last inspection.

Although there some instances of lateness, overall, people using the service and relatives told us their care workers turned up on time and they received the same care worker on a regular basis. There was consistency in the level of care they received. The service had a system in place to monitor care workers punctuality. However, people were not being informed promptly about changes with their care workers. The registered manager told us they would review this and ensure people were communicated with more effectively.

People and relatives told us that they were confident that most care workers had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working for the service.

Care workers had a good understanding of the importance of treating people with respect and dignity. Feedback from relatives indicated that positive relationships had developed between people using the service and their care worker and people were treated with dignity and respect.

Systems and processes were in place to help protect people from the risk of harm and care workers demonstrated that they were aware of these. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Risk assessments had been carried out and care workers were aware of potential risks to people and how to protect people from harm.

Arrangements were in place in respect of medicines. Care workers had received medicines training and policies and procedures were in place. We looked at a sample of Medicines Administration Records (MARs) and found that all these were completed fully which indicated that people had received the medicines they were prescribed.

People received care that was responsive to their needs. People's daily routines were reflected in their care plans and the service encouraged and prompted people's independence. Care plans included information about people's preferences.

The service had a complaints procedure and there was a record of complaints received. There was a clear management structure in place with a team of care workers, office staff, care coordinator, internal trainer, care manager, the branch manager, the registered manager and the provider.

Staff were informed of changes occurring within the service through regular staff meetings. Staff told us that they received up to date information and had an opportunity to share good practice and any concerns they had at these meetings.

Systems were in place to monitor and improve the quality of the service. We found the service had obtained feedback about the quality of the service people received through review meetings, telephone monitoring and satisfaction surveys. Records showed positive feedback had been provided about the service.

The service also undertook a range of checks and audits of the quality of the service and took action to improve the service as a result.

10/9/2015

During a routine inspection

We undertook an announced inspection on 10 September 2015 of ANA Nursing. ANA nursing is registered to provide the regulated activity nursing care/personal care and provides personal care, housework and assistance with medicines in people’s homes.

At the time of the inspection, the service was providing care and supporting 35 people and had 60 care workers working for them.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection on 29 September 2014, the service did not meet Regulations 21 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond to Regulation 19 of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014. At this inspection the registered manager was able to demonstrate that measures had been put in place since the last inspection to respond to the issues identified.

However, we found people experienced a lack of consistency in the care they received. Some people did not have regular care workers and were also not aware of which care worker was coming to support them.

Risks to people were identified. Although the risk assessments were specific to people’s individual needs, it was sometimes unclear as to whether identified risks were being managed appropriately and what measures were in place.

Records showed and staff told us they received regular training and received support from the registered manager. Appropriate checks were carried out when staff were recruited. However, people using the service and relatives told us they felt the care workers were not sufficiently trained to provide the care and support people needed.

There were some arrangements in place to obtain, and act in accordance with the consent of people using the service. People’s care plans contained an agreement section which indicated they had given their consent for the care to be provided. However care plans did not contain any information about a person’s mental capacity and levels of comprehension.

Some people spoke positively about the care workers, however we found instances where people experienced a lack of consistency in the care demonstrated by staff and there were instances where people were not treated with dignity and respect.

People’s plans consisted of a care needs assessment, a support plan and risk assessments. However the care plans were difficult to follow as information was duplicated at times and were tasked focused. Information was not clear about people’s nutritional and hydration needs.

We have made one recommendation abut managing risks and safeguarding people

We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.