Mike Riglin Nursing

Mike Riglin Nursing is a domiciliary care agency providing nursing and personal care. The people they supported included people over the age of 18, people with dementia, people with a physical sensory, learning disability and autistic people and those with mental health needs. At the time of the inspection, they were supporting 27 people living in their own homes within the local community.

Not everyone who used the service received personal or nursing care. CQC only inspects where people receive personal or nursing care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were supported to achieve consistently positive outcomes, which improved their wellbeing and enhanced their quality of life. They received support from consistent staff who knew them well and how they liked to be supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People's needs were assessed, and care records developed with them, and their relatives where required. Care records were updated regularly and clearly promoted preferences and choice. Medicines were managed safely, and staff were appropriately trained and recruited. People and their family members were assured that safe infection control measures were taken by staff such as wearing personal protective equipment (PPE) and following infection control procedures to reduce the risks of infection.

Right Care:

People received outstanding kind and respectful care. People and their family members, without exception, told us staff were warm, caring, and compassionate and went ‘above and beyond’ to provide a high level of care. People were actively involved in planning and reviewing their care and support. Staff were proactive in developing ways to ensure people could communicate their wishes and views and be fully involved in decisions about their life.

Right Culture:

The service was very well-led. Managers led by example and were visible in the service. They were passionate about ensuring the service delivered care and support based on their values and principles, that people’s rights to choice, control, and autonomy were respected. Governance arrangements were well embedded, and this ensured people received consistently safe, effective, and very high-quality care. Staff were highly motivated and extremely proud of the work they did. People using the service and their family members told us they would highly recommend the service to others. The service worked collaboratively and responsively with healthcare professionals to plan extremely person-centred care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 29 June 2019).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mike Riglin Nursing on our website at www.cqc.org.uk.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Not everyone using Mike Riglin Nursing receives personal care; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of the inspection the registered provider was also the registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

At the last inspection in August 2016, the service was rated 'Good'. At this inspection we found the service had maintained a rating of ‘Good'.

The manager ensured there was a number of different systems and processes in place to assess and monitor the quality and standard of the care being provided.

People were receiving safe, compassionate and effective care and told us that the provision of care was of a good standard. During the inspection we reviewed care plans and risk assessments which were in place. Records were well maintained, contained up to date and relevant information and were regularly reviewed. Staff said that records enabled them to provide the level of support which was required and risks were always assessed, monitored, safely managed and communicated amongst the staff team.

Policies and procedures contained relevant, up to date information and were available to all staff as and when they needed them. Staff were familiar with 'safeguarding' and 'whistleblowing' procedures. Staff knew how to report any concerns and had completed the necessary safeguarding training.

Care plans were individually tailored and a 'person centred' approach to care was evident throughout the records we reviewed. People told us that staff were familiar with their support needs and always provided care and support in a respectful and dignified way.

We reviewed medication management systems during the inspection. People had the relevant medication care plan in place which included detailed information in relation to medication administration times, medical history and the level of support required. There was a medication consent form which had been signed by each person who was being supported and staff had received the necessary medication training.

We reviewed the manager’s recruitment processes. All staff who were working for the manager had suitable references and disclosure and barring system checks (DBS) in place. DBS checks ensure that staff who are employed are suitable to work within a health and social care setting. This enables the manager to assess level of suitability for working with vulnerable adults.

Staff told us they were fully supported in their roles. Staff received regular supervisions and annual appraisals. Training was regularly provided as well as specialist training being offered to help support with learning and development.

Accidents and incidents were being routinely recorded and monitored. The manager ensured that accidents/incidents were being assessed and trends were being established.

The day to day support needs of people were well managed by the manager We saw evidence of appropriate referrals taking place, correspondence between external healthcare professionals as well as the necessary risk management tools being used to monitor people's health and well-being.

The manager had suitable quality assurance audits, checks and assessments in place. Such measures ensured that people were receiving a safe level of care and support in relation to their support needs. Quality assurance tools ensured that the quality, standard and provision of care was being monitored, assessed and improved upon.

The manager was aware of their responsibilities and understood that CQC needed to be notified of events and incidents that occurred in accordance with the CQC's statutory notifications procedures. Statutory notifications were being appropriately submitted in a timely manner.