Background to this inspection
Updated
2 July 2019
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
This inspection was carried out by one inspector and an assistant inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 11 June 2019 and ended on 13 June 2019. We visited the office location on 11 June 2019.
What we did before the inspection
Prior to the inspection we looked at the statutory notifications and other intelligence we had received about the service and used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
One person who received support spoke to us about their experience of the care provided and we spoke to five relatives. In addition, we spoke with six members of staff including the nominated individual, registered manager, two case managers, and two support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included five people’s care records. We looked at five staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including audits, accidents and incidents and complaints were also reviewed.
Updated
2 July 2019
About the service
N-Able Services Ltd provides specialist case management, support and rehabilitation services to children and adults with acquired brain injuries and other complex disabilities. N-Able services are commissioned through personal and medical injury firms and they manage the day to day care packages on behalf of clients. N-Able Services Ltd employs professional case managers and therapists and is also responsible for the recruitment and line management of support staff, utilising the services of other care providers where appropriate. At the time of inspection, the service was supporting 19 people who received care and support.
Not everyone who used the service received personal care. 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.
People’s experience of using this service and what we found
People received consistent person centred support from staff who were kind and caring. People's needs had been fully assessed and support plans were detailed and reflected people's individual needs and preferences. Support needs were reviewed regularly. Staff understood the needs of the people they supported and had developed positive relationships.
Risks to people had been identified and staff had clear guidance to manage and reduce risk. People were protected from the risk of harm and abuse and everybody we spoke to felt confident to raise any concerns.
Safe recruitment practices were in place and people were supported by staff who had undertaken a thorough induction process and training relevant to their roles. Enough staff were employed to meet the needs of the people using the service. Staff were supported through regular supervision and team meetings, and felt well supported by the registered manager.
Medicines were administered by trained and competent staff and staff had access to personal protective equipment (PPE) to prevent and control the spread of infection.
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 independence was promoted and their right to privacy and dignity respected. People and their relatives spoke positively about the staff and management team and told us their views and feedback were regularly sought.
People knew how to make a complaint and they were confident about raising concerns should they need to.
The registered manager was described as supportive and approachable. They worked in partnership with other agencies to ensure people received care and support that was consistent with their assessed needs.
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 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
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.