Background to this inspection
Updated
27 April 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
This inspection was carried out by one inspector and was announced. An expert by experience made telephone calls to interview people or their relatives. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type: The Independent Nursing and Care Agency (INCA) is a domiciliary care agency providing care and support to mostly older people who live in the community.
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:
We gave the registered manager 48 hours’ prior notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.
We visited the office location on 11 March 2019 to see the registered manager and office staff; and to review care records and policies and procedures.
What we did:
¿Prior to the inspection we looked at all the information we had collected about the service including previous inspection reports and notifications the registered manager had sent us. A notification is information about important events which the service is required to tell us about by law.
¿We reviewed the information the provider sent us in the Provider Information Return. 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 also contacted two community professionals for feedback and received one response.
¿During the inspection we spoke with two people who use the service and five relatives. In addition, we spoke with the registered manager, the director and four members of the staff team.
¿We looked at records relating to the management of the service for example:
• four people's care plans and associated records
• four recruitment records
• staff training records
• supervision, spot checks and observations
• incident and accident records
• quality assurance records
• the compliments and complaints
• policies relating to the running of the service
¿Following the inspection, we asked the provider for some further information which we received. This included follow up information on survey analysis, meeting minutes and policies relating to the running of the service.
Updated
27 April 2019
About the service: The Independent Nursing and Care Agency (INCA) is a domiciliary care agency providing care and support to mostly older people who live in the community. At the time of our inspection there were 18 people using the service and receiving personal care.
People’s experience of using this service:
¿The registered manager did not ensure the management of medicine was safe at all times. They could not evidence that staff were assessed as competent to handle medicine.
¿The registered manager did not always record the way they reviewed, assessed and monitored the quality of service provided. They did not always record they had carried out audits to check the quality of service provision and people’s care records.
¿The registered manager encouraged feedback from people and relatives, which they used to make improvements to the service.
¿Not all staff had completed recent training refreshers as per their annual timetable. The registered manager had planned and booked training when necessary to ensure all staff had the appropriate knowledge and skills to support people. Staff had ongoing support, supervision and appraisals. They felt supported by the registered manager and senior staff.
¿We have made a recommendation that future ongoing staff training be updated in line with the latest best practice guidelines for social care staff.
¿People felt safe while supported by the staff team who made them feel reassured. Relatives agreed with this.
¿Staff understood how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. The registered manager had the knowledge to identify safeguarding concerns and to act on these appropriately.
¿The service assessed risks to the health and wellbeing of people who use the service and staff. Where risks were identified action was taken to reduce the risk where possible.
¿People received care that was designed to meet their individual needs and preferences. 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.
¿People were treated with respect, and their privacy and dignity were promoted. People felt the staff supported them in the way they wanted. Staff were responsive to the needs of the people and enabled them to improve and maintain their independence with personal care.
¿Staff felt the registered manager was approachable and considerate. They had good communication, worked well together and supported each other. The registered manager praised the staff team for their hard work and appreciated their contribution to ensure people received the best care and support.
¿Recruitment processes were in place to make sure, as far as possible, people were protected from staff being employed who were not suitable.
¿The staff monitored people's health and wellbeing and took appropriate action when required to address concerns.
¿People's right to confidentiality was protected and their diversity needs were identified and incorporated into their support plans where applicable.
Rating at last inspection: At the last inspection the service was rated Good in all the domains (Report was published 05 October 2016).
Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.
Enforcement: Full information about CQC's regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.
Follow up: We will continue to monitor all information we receive about this service. This informs our ongoing assessment of their risk profile and ensures we are able to schedule the next inspection accordingly.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk