Niche Care Wakefield

Updated 10 November 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team was made up of one inspector and one bank inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. The manager was in the process of applying to register with the CQC.

Notice of inspection

We gave the service 24 hours' notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on 7 October 2021 and ended on 12 October 2021. We visited the office location on 12 October 2021.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority commissioners and safeguarding team, and from Healthwatch, Wakefield. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with eleven people who used the service and three relatives about their experience of the care provided. We met with the manager and director of operations. The director of operations was representing the provider. We spoke with seven members of care staff.

We looked at written records, which included four people’s care records and four staff files. A variety of records relating to the management of the service were reviewed.

After the inspection

We continued to seek clarification from the manager to validate evidence found. This included reviewing people’s care records and quality assurance processes.

Updated 10 November 2021

About the service

Niche Care, Wakefield is a domiciliary care agency. It provides personal care to adults with a range of support needs in their own homes in the Wakefield area. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of this inspection 61 people were receiving support with personal care.

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

Some significant improvements have been made by the new provider since our last inspection, however we need to see these improvements fully implemented and then sustained. In particular, people’s risk assessments and the provider’s quality assurance systems need to be further developed. We have also made two recommendations regarding recording capacity to consent to care and responding to feedback.

Safe recruitment procedures made sure staff were of suitable character and background. Staff had received training in safeguarding vulnerable adults. There were enough staff deployed to meet people’s care and support needs. People received their medicines as prescribed.

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. Staff were provided with an induction and relevant training to make sure they had the right skills and knowledge to support people. Staff told us the manager was approachable and they felt supported in their jobs. People were supported to maintain good health and have access to health and social care services.

Positive and supportive relationships had been developed between people, their relatives and staff. People told us they were treated with dignity. People’s care and support was planned and delivered in a way that ensured it met their needs and reflected their preferences. Care records were being updated to reflect this. There were systems in place to respond to complaints. People told us they knew how to complain, and the manager and office staff were responsive to any concerns they raised.

The provider had a comprehensive set of policies and procedures covering all aspects of service delivery. People using the service, their relatives and staff told us they could see improvements were being made at Niche Care, Wakefield.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 26 April 2021). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection.

We met with the new provider and they have completed an action plan with the local authority to show what they would do and by when to improve.

At this inspection not enough improvement had been made and the new provider was in breach of one regulation.

This service has been in Special Measures since 26 April 2021. During this inspection the new provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focused inspection to check the new provider had followed their action plan and to confirm whether they now met legal requirements. This report only covers our findings in relation to the Key Questions of safe, effective, responsive and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to risk assessments and quality assurance processes at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an updated action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.