Archived: Newcross Healthcare Solutions Limited (Bristol, Bath & North Somerset Service)

People’s experience of using this service:

The service was rated Requires Improvement at the last Inspection in April 2018. This was because the service was not always safe at that time. The service did not have enough suitably qualified and experienced staff to meet the needs of their care packages at that time. The service had not always been responsive to people’s needs. People had told us they did not always have positive experiences when contacting the office with queries or concerns. It was also because the provider had not acted quickly enough to mitigate the risks of not having enough staff. At this inspection we found that actions had been taken and the rating of the service in these areas had improved to Good.

The service was safe and risks to people continued to be assessed and were well managed. Risks were identified and assessments in place that were reviewed regularly . This helped to promote safety and a good quality of care.

People received care and support that was well planned and responsive to their needs. Each person’s needs and wishes were placed at the centre of how their care was planned. The service had built up to be a compassionate and innovative organisation.

The service worked closely with other professionals and organisations involved in people’s care. There were different innovative ways people were supported, for example to go swimming. These helped prevent the risk of social isolation and enhance quality of lives. People were supported to be engaged in activities away from their homes.

The registered manager was a positive and transparent role model. They took a leading role conveying values and standards they expected staff to follow and embrace. They did this by looking at continuous improvement. They also made sure they led the service in a way that always meant positive outcomes for people.

Regular social activities, events and networks were held and people were isolated were supported to go to these.

The manager always aimed to improve the quality of service. There were effective ways used to seek people's views on the service. The quality of the service was checked and monitored.

Rating at last inspection: The service was rated Requires Improvement at the last Inspection in April 2018.

Why we inspected: This was a scheduled inspection based on the rating at the last inspection.

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

The service provides care for people with complex care needs. The service provides care to both adults and children. At the time of our inspection the service was providing 28 packages of care.

There was a registered manager in place, although they were shortly to be going on long term leave. A manager had been found to cover whilst the registered manager was absent. 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.

We found that the service required improvement. People were not consistently kept safe because there weren’t sufficient numbers of suitably qualified staff to meet the demands of people’s care packages. This had led to a significant number of calls being cancelled by the agency because they weren’t able to provide cover. People using the service were supported by family and so their immediate safety was not put at risk by the calls being cancelled, however it was clear from feedback provided that the situation was impacting negatively on people and causing them distress. The service was reviewing their recruitment procedures to try and improve the situation.

The service had not been well led in all aspects. Historically, the management of acquiring new care packages had not been well managed and this was impacting on the service’s current performance.

We received positive comments about the care staff and people had clearly built up good, strong relationships them. It was clear that regular staff understood and met the needs of the people they supported. However frustrations arose when visits were cancelled by the service. This was reflected in both feedback from people and professionals involved with the service.

There were systems in place to manage complaints, however there was a lack of confidence amongst service users and professionals about how their concerns would be responded to. Feedback was inconsistent, some people were satisfied about how the service managed their complaint, others expressed frustration and concern about the process.

Staff were required to have the skills to support complex health needs and conditions. It was clear from staff records that their skills and abilities were monitored closely. There were lead registered nurses in place overseeing care packages and reviewing them regularly.

Staff understood their responsibility to safeguard vulnerable adults and had received training in this. There were safe processes in place to support people with their medicines where this was part of their agreed care package. Medicine Administration Records (MAR) were reviewed and checked regularly to monitor for any errors or omissions.

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