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Nationwide Care Services Limited (Derby) Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 5 December 2017

This inspection took place on 24 October 2017 and was announced.

We carried out an announced inspection of this service on 4, 5, 6 and 7 April 2017. Five breaches of legal requirements were found and we rated the service as 'Inadequate'. This was because the provider had failed to: submit statutory notifications when required; identify, receive, record, handle and respond to complaints effectively; ensure suitable staff were employed; provide people with safe care; and operate effective systems to assess, monitor and improve the service, and mitigate risks to the health, safety and welfare of the people using it.

Following this inspection we also took action to restrict new admissions to the service. We also issued a requirement for the provider to send us monthly reports on the progress they had made towards improving the service.

In response the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. At this inspection we found that action had been taken and the breaches had been met. As a result we have lifted our requirement to restrict new admissions to the service.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

Nationwide Care Services Ltd provides personal care and support to people in their own homes in Derby and the surrounding areas. At the time of this inspection 50 people received personal care from the service.

The service did not have a registered manager. A registered manager 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. The manager told us they were in the process of applying to CQC to be the next registered manager.

We found significant improvements to the service. Medicines were managed safely and people told us they received them at the right times. Staff were trained to administer medicines safely and medicines records were audited to ensure they were of an acceptable standard.

Care plans and risk assessments had been re-written and improved so that risks to people were safely managed and they were protected from harm. Care plans were personalised and included an explanation of what people wanted to achieve with the support of their care workers People told us they were involved in making decisions about their care and had access to their care plans.

The provider’s recruitment procedure, which helped to ensure the staff employed were safe to work with the people using the service, had been followed. An improvement was needed to the staff risk assessment procedure to ensure it was fit for purpose.

The provider’s complaints procedure had been followed and people who raised concerns had been listened to and told of the outcome of their complaints and what was being done to improve the service in response. Most people said they were satisfied with how staff responded to complaints.

Most people said they were happy with the staff who supported them and said they provided safe care. Staff knew how to protect people from harm. They were well-trained and had completed a range of courses designed to give them the skills and knowledge they needed for their work. Some improvements were needed in the way the Mental Capacity Act was implemented at the service.

The service promoted equality and diversity and management followed the provider’s policy on delivering a culturally appropriate service. The staff team was made up of people with a range of skills including the ability to cook culturally appropriate food and speak a number of local languages.

There were effective systems in place to monitor quality. The managers carried out regular audits of all aspects of the service. If these revealed shortfalls the managers and staff took action to bring about improvements. Statutory notifications were submitted to the CQC when required and these showed that the staff had taken appropriate action to safeguard people when incidents had occurred.

The results of the provider’s latest quality assurance survey showed that people’s satisfaction with the service had increased in all areas. Some people said they would recommend the service to others and praised the caring nature of the staff.

Inspection areas

Safe

Requires improvement

Updated 5 December 2017

The service was mostly safe.

People using the service felt safe and staff knew what to do if they had concerns about their welfare.

Staff supported people to manage risks.

There were enough staff employed to keep people safe and meet their needs. Further improvements were needed to staff recruitment procedures.

Medicines were safely managed and administered in the way people wanted them.

Effective

Requires improvement

Updated 5 December 2017

The service was mostly effective.

Staff were trained to support people safely and effectively.

Improvements were needed to the way the Mental Capacity Act was implemented at the service.

Staff had the information they needed to enable people to have enough to eat and drink and maintain a balanced diet.

People were assisted to access health care services and maintain good health.

Caring

Good

Updated 5 December 2017

The service was caring.

Staff were caring and kind and treated people as individuals.

Staff respected people’s privacy and dignity and involved them in decisions about their care and support.

Responsive

Good

Updated 5 December 2017

The service was responsive.

People received personalised care that met their needs.

Complaints were taken seriously and managers took action to investigate them and make improvements where necessary.

Well-led

Requires improvement

Updated 5 December 2017

The service was mostly well-led.

The service did not have a registered manager.

The service had an open and friendly culture and the staff were approachable and helpful.

The provider and managers welcomed feedback on the service provided and made improvements where necessary.

The provider used audits to check on the quality of the service.