7 October 2023
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
The inspection was undertaken by 1 inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave a short period notice of the inspection. This was because we needed to check that the service had systems in place which could accommodate the remote inspection.
Inspection activity started on 18 September 2023 and ended on 29 September 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video and telephone calls to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.
We spoke with a director on 18 September 2023 and explained the inspection process and checked they were able to send documents via the secure portal. On 20 September 2023 we spoke with, via video call, a director and registered manager who is also a director and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. During the video call, we were shown the electronic systems for the management of medicines, audits and how visits were planned and monitored.
A range of records were shared with us on a secure portal, including 10 people’s care plans and risk assessments. We also reviewed records including 3 staff recruitment, staff training, quality assurance, complaints, safeguarding and policies and procedures.
We received electronic feedback from 8 staff members. We spoke with 14 people who used the service and 12 relatives on the telephone. We also saw a video made by the service for a staff awards ceremony, where 7 people using the service shared their views about the service and their care staff.
On 29 September 2023 we fed back our findings to a director and the registered manager / nominated individual via video call.
7 October 2023
About the service
Nayland Care Agency Limited is a domiciliary care service providing personal care support to people living in their own homes. The service provides support to older people, people living with dementia, people who may have a physical disability, learning disability and/or sensory loss. The service was also working in partnership with the local authority providing a ‘reablement’ service which supported people for a period of time to gain their independence following, for example, a hospital stay.
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. At the time of our inspection there were 130 people receiving the regulated activity of personal care.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability.
The management team told us they were aware of the Right support, right care, right culture guidance and considered this in line with the care provided. The service had ensured staff were provided with training in supporting people who have a learning disability and autistic people.
Staff received training in how to meet people’s needs, this included training in people’s diverse needs, such as dementia. Staff were observed in their work practice and received support and guidance in their work role.
Systems were in place to reduce the risks of avoidable harm and abuse. Lessons were learned when things went wrong, and these were shared with staff. People were supported with their medicines, where required and staff were trained, and their competency checked to reduce risks. Staff were recruited safely and there were sufficient numbers of staff to ensure care visits were completed. Staff received training in infection control and had access to personal protective equipment (PPE).
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. Prior to using the service, people’s needs were assessed, and these assessments were used to inform their care plans and risk assessments, which were kept under review. People’s care records identified the care and support people required to meet their assessed needs and the service delivery was monitored by the management team to ensure the care plans were being followed.
People were supported by staff who were in the majority caring and compassionate. We received some comments from people and relatives where improvements could be made in individual staff member’s approach. However, we were assured the management team were monitoring and assessing the care provision and any concerns identified were addressed.
People’s independence, dignity and privacy was being respected. People were asked for their views about the service and their comments were listened to and acted on. This included their decisions about their care and, where required, their end-of-life support.
The management team had systems in place to monitor and assess the service, which supported them to identify shortfalls and address them. The management team were committed to providing high quality care and continued to improve.
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 12 September 2018).
Why we inspected
This comprehensive inspection was prompted by a review of the information we held about this service.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nayland Care Agency Limited on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and telephone calls to engage with people using the service as part of this performance review and assessment.