We carried out a review of the data available to us about Napier Homecare Services Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Napier Homecare Services Limited, you can give feedback on this service.
Napier Homecare Services Limited provides domiciliary services to 147 people who require support in their own home at the time of our inspection. The service supports a wide range of people in the community and operates seven days a week. Napier Homecare Services Limited will be referred to as Napier Homecare within this report.
People’s experience of using this service and what we found
People confirmed their medication was managed safely. One person said, “No problems, yes they watch me while I take the medication.” The manager enhanced infection control procedures and ensured staff had sufficient equipment during the pandemic. People and their relatives stated they felt safe and staff had training to enhance their skills to protect each person.
People and relatives experienced Napier Homecare as a friendly, professional service and told us the management team had a positive impact on care. Staff stated they worked well together and found the new manager was supportive and caring.
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 good (published 18 May 2018).
Why we inspected
We wanted to assure ourselves the service remained safe since our last inspection and continued to be led well under the new manager.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Napier Homecare on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At our last inspection in January 2016, we rated the service as good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
During this inspection, people told us they felt safe using Napier Homecare. When we discussed safeguarding people from abuse or poor practice with staff, we found they had a good knowledge about related procedures.
The registered manager followed safe recruitment practices to protect people against the employment of unsuitable personnel. They had a system to monitor care packages to ensure people received support on time and as agreed. This enabled them to monitor staffing levels against care delivery requirements. All staff were required to complete the care certificate to give them all-round knowledge of their roles and responsibilities.
We found the registered manager assessed risks to people from receiving unsafe or inappropriate care in their own homes. They recorded incidents, injuries and action taken to mitigate the occurrence of risk.
People received their medicines on time and with a safe approach where this formed part of their care package. Staff had relevant training and demonstrated good practice when administering medication, such as washing their hands beforehand.
Where staff supported people with their nutritional needs as part of their packages of care, we saw they developed relevant care plans.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. There was a clear and consistent message from those we discussed care delivery with that staff sought their consent.
We found staff respected people’s dignity and treated them with kindness during care visits. One person told us, “Nothing’s too much trouble.” Care plans we reviewed were focused upon helping people to maintain their independence. Records demonstrated each person or their relative was involved in the development and planning of their care packages.
Care delivery centred on a consistent approach to ensuring staff engaged with people whilst supporting them. We saw the management team guided staff to people’s life histories and preferences to help them understand the person’s backgrounds.
People and their relatives said the management team proactively sought their feedback about the quality of care and the home’s development. Staff told us they had a high level of support from the management team and felt appreciated as employees of the service. A staff member stated, “I can ring up the office at any time if I have problems. [The management team] are very on the ball and will sort anything out.”
Further information is in the detailed findings below.
The inspection visit at Napier Homecare was undertaken on 20 and 22 January 2016 and was announced. 48 hours’ notice of the inspection was given to ensure people who accessed the service, staff and visitors were available to talk with us.
Napier Homecare provides personal care assistance for people who live in their own homes. The service supports people living with dementia or mental health conditions, or those with physical disabilities.
A registered manager was in place. 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 2008 and associated Regulations about how the service is run.
At the last inspection on 17 June 2014, we found the provider was meeting all the requirements of the regulations inspected.
During this inspection, we were told people felt safe whilst being supported in their own home. One person said, “Oh yes, I feel very safe in their hands.” Staff had received safeguarding training and demonstrated a good understanding of related principles.
People told us they had consistency of staff, which helped them to feel safe. They said there were enough staff to meet their requirements. All staff had completed or were in the process of undertaking the Care Certificate to underpin their skills. The management team had followed safe recruitment practices to ensure suitable personnel were employed
The registered manager had introduced new systems to ensure people’s medicines were managed safely. Individuals who accessed the service told us they felt fully supported when assisted with their medication.
People we spoke with said staff were effective in meeting their needs. One person told us, “I cannot stress enough how much I could not do without them.” Staff exhibited a good understanding and practice of the Mental Capacity Act (MCA) and associated Deprivation of Liberty Safeguards (DoLS). Care records contained evidence of the person’s consent to their support and people said staff checked this prior to assisting them. A relative told us, “The staff know their boundaries and what helps [my relative] and what doesn’t. They never take over.”
Care records we reviewed were personalised to each person’s preferences. People were involved in the ongoing assessment of their care requirements. They said they had been provided with information about how to comment on their care if they chose to.
We observed staff were caring and kind when they engaged with people. They demonstrated an effective understanding of the principles of good care and maintaining people’s privacy and dignity. People said staff supported them to maintain their self-determination. A staff member told us, “We are there to improve and promote the individual’s independence.”
People who accessed Napier told us they felt it was well managed and organised. The registered manager had completed a range of audits to ensure people’s welfare was maintained. The management team sought people’s views in order to assess quality assurance as a part of the ongoing development of the service.
Information we gathered during the inspection helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the agency, staff supporting them, and from looking at records. This helped us to gain a balanced overview of what people experienced receiving support from Napier Homecare.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us that they felt safe. We were told that staff were kind and caring. People also told us they felt respected by the staff who supported them and that their dignity was protected. Comments included, 'They have been coming to me for some time. They are all patient and very kind'. Also, 'I look forward to seeing them they are good company'.
Staff had the knowledge, skills and protective equipment to ensure people were protected from the risk of infection. Staff told us they collected gloves and aprons on a weekly basis from the office to enable them to carry out their roles safely.
Staff had received training and support in medication management which meant that people received their medication safely.
People were safe because staffing levels were assessed and monitored to ensure they were sufficient to meet people's needs.
Is the service effective?
People were receiving care and support usually from the same staff who understood their needs, so that it was delivered at the right time in ways they wanted. One person told us, 'We like the way we get the same staff. It's important to get to know the people coming into your home'.
People's health and care needs were assessed with them, and they were involved in writing their plans of support they required at home. We saw evidence of this when looking at peoples care and support plans. They were up to date and reflected their current support needs. One person said, 'They always check what needs to be done and ask if everything is ok when they come here.'
Is the service caring?
We spoke with people being supported by the service. We asked them for their opinions about the staff who supported them. Feedback from people was positive, for example; "Can't fault them one bit. Couldn't ask for better staff'. Also, "I really I look forward to their visits they are all very caring'.
When speaking with staff they demonstrated their commitment to provide quality care for people they supported. Comments included, 'I hadn't done this type of job before but it's so rewarding and people really appreciate the care you are providing in their own home'. Also, 'I've worked in care for a long time. I wouldn't still be doing it if I didn't want to care for people'.
Is the service responsive?
People's care and support needs were assessed with them, and they were involved in the development of their plans of support. We saw care plans were up to date and reflected peoples current support needs. One person said, 'They always check what needs to be done and ask if everything is ok when they come here'.
The agency listened to what people's choices were in order to respond to the level of care and support identified. One person told us, 'It was difficult when I lost my relative but the staff were really supportive and changed the times they came. This really helped me get through'.
Is the service well led?
There were a range of audits and systems put in place in by the manager to monitor the quality of the service being provided. This helped to ensure people received a high standard of service delivery.
Comments we received from people using the agency and by talking with staff, confirmed their views on the service were regularly sought. Staff told us the manager constantly communicated with them and informed them of changes where necessary. Comments included, 'There are regular spot checks. It keeps you on your toes'. Also, 'I feel I could comment on anything I was not sure about or unhappy about. I have the confidence it would be listened to and acted on'.
One person told us, 'I use the service constantly, every day, they have been very good to me I am very happy. I feel safe and well and certainly would not want to have anyone else.' A second person told us, 'I have used the service for 3 or 4 years. They visit 4 times a day. Some are bit funny on time keeping; they are not good at getting up.' A third person told us, '.Sometimes the times are a bit on and off and sometimes earlier and some the proper time'. A fourth person told us, 'They have only been coming for a few weeks. They are very good and my relative liked the care straight away.'
A pre assessment and care planning was undertaken. Care plan records had been reviewed. The records showed us that people were fully involved and consulted regarding their care and support.
There were contingency measures in place regarding emergency care people may require. There was an emergency on call system available for staff for advice and guidance.
We looked at this outcome because we had received concerns regarding the use of out of date food and lack of support for people at mealtimes. The registered manager had devised and implemented a new green care planning system. This indicated when a person had been assessed as having memory problems and could be potentially at greater risk of eating and drinking.
We looked at this outcome because we had received some concerns regarding the times people received support to take medication at the times they were prescribed. The provider had since taken action to improve their systems in order to ensure people were supported to take their medication as prescribed by their GP.
Our discussions with staff confirmed they were supported with their personal development and training.
The agency had worked with the local council in order to ensure steps had been taken to improve the services they were providing.
'My carer has just left and I will miss her, she's been like a friend'.
'On the whole we have got some good girls'.
'I am happy with the service it's been very good'.
"The only problem can be Christmas and Bank Holiday cover; it can be awkward as we didn't know who was coming'.
We spoke to people about their experiences being supported by the agency and was told their carers provided sensitive and flexible personal care support and they felt well cared for. We were told their carers had the skills necessary to ensure people they support are treated with respect and dignity. People told us that staff were very good at ensuring they take they medications.
'Staff get my tablets out of the blister pack and put them in a little cup for me. I always take them before staff leave.'
'Staff put in my ear and eye drops for me. They all seem to know what they are doing'
'Staff are very reliable and never let me down. They are respectful and treat me with dignity'
'Staff are more than polite. I would be lost without them.'
'Staff are very nice caring people'
'Staff are absolutely great' they are my friends as well as my carers'.