Jadee's Nursing Agency

About the service

Jadee’s Nursing Agency is a home care agency providing personal care to 24 people at the time of the inspection. There were 2 people with a learning disability being supported by the service. The service also supported people with physical disabilities, sensory impairments and people living with dementia.

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

Right Support: Improvements had been made to the model of care to maximise people’s choice, control and independence, including in relation to the Mental Capacity Act. Visits were being organised, monitored and delivered safely through effective use of an electronic call monitoring system, which meant people could organise their day as they wished. 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.

Right Care: Staff were described as caring, compassionate, and kind. People told us they were involved in the planning of their own care, and feedback given to the service was listened to and acted on. Improvements had been made to care planning and risk assessments, although further development was still required as some language used was outdated. We have made a recommendation the provider consults best practice guidance as a result. Staff received training on how to meet people’s needs, including specialist training in how to support autistic people and people with a learning disability.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff supported people using services to have good outcomes. There had been numerous changes and improvements made at the service since the last inspection, and the provider was committed to continuous development and working with others. Some new systems and processes still needed further development to show they were embedded and sustained in the longer term. We have made a recommendation about consistent analysis to identify and act on themes and trends. Whilst some regulatory requirements were not fully met, the provider acted promptly when this was raised.

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 28 January 2023). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 16 January 2023. During this inspection the 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

This inspection was prompted by a review of the information we held about this service. We also undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

Recommendations

We have made a recommendation on the consistent use of person-centred language in care records, development of end of life care plans, and a recommendation on the meaningful analysis of themes and trends to drive improvement.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Jadee’s Nursing Agency is a home care agency providing personal to 34 people at the time of the inspection within the Suffolk area. They also operate as a recruitment agency supplying social care staff to care homes and supported living services. However, we did not cover this side of the service as it falls outside the scope of the CQC’s regulation.

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

Right Support: This means the model of care and setting maximises people’s choice, control and independence. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. This was because record keeping on legal representatives was not in place, and assessments on people’s capacity had not been completed where they may not be able to consent to all aspects of their care. We raised this with the registered manager and the director, who told us they would put this in place immediately.

Right Care: This means that care is person-centred and promotes people’s dignity, privacy and human rights. Whilst staff were described by people as caring and kind, they had not been provided with specific training by Jadee’s Nursing Agency on how to support people with a learning disability or autistic people. This meant they would not have the knowledge to support people in a way to meet their specific needs. There was also a lack of systems, such as ensuring appropriate capacity assessments were in place, to ensure staff could support people in the least restrictive way.

Right Culture: This means the ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. The governance and oversight of the service did not promote this, as there was a lack of awareness as to Right Support, Right Care, Right Culture guidance and mandatory training requirements. However, the management team were open to making the improvements identified during the inspection process.

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

Rating at last inspection

This service was registered with us on 4 June 2020 and this is the first inspection.

Why we inspected

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

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to safe care and treatment, recruitment of staff, staffing and deployment, safeguarding, consent, complaints handling and good governance at this inspection.

We issued a Warning Notice for Regulation 17 (Good governance).

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of their registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.