Archived: Total Care Nursing Limited

Updated 19 November 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection, we sent out surveys to ten people who used the service. Six were returned and we have included their responses in the inspection report. We also reviewed all the information we held about the service. This included any statutory notifications that had been sent to us. We contacted the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

This inspection took place on 14 September 2015 and was announced. The provider was given 48 hour notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office. An adult social care inspector and an expert-by-experience carried out the inspection. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert had experience in older people’s services.

At the time of this inspection there were ten people receiving personal care from Total Care Nursing Limited. We spoke on the telephone, with six people who used the service, two relatives and six staff. We visited the provider’s office where we spoke with the registered manager and office manager, and spent some time looking at documents and records that related to people’s care and support and the management of the service. We looked at three people’s care and support plans.

Updated 19 November 2015

This inspection took place on 14 September 2015 and was announced. At the last inspection in August 2013 we found the provider was meeting the regulations we looked at.

Total Care Nursing Limited is registered to provide personal care to people in their own home. At the time of the inspection, the service had a registered manager. 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.

People we spoke with told us they were very happy with the care they received and were complimentary about the staff who supported them. They told us the service was well managed. People consented to their care but where they lacked capacity a formal assessment was not always completed. People received assistance with meals and healthcare when required. People were involved in planning their care and, in the main, care and support needs were assessed and plans usually identified how care should be delivered.

People told us they felt safe. Staff understood how to keep people safe and told us any potential risks were identified. There were appropriate arrangements for the safe handling of medicines.

Everyone we spoke with said the staffing levels were good. People who used the service said the same care workers visited, staff always stayed the agreed length of time and their visit times suited their needs and wishes. Safe recruitment practices were followed.

Staff felt well supported by the management team but the provider did not have an effective system that ensured staff had completed all the training and support that equipped them with the skills and knowledge to do their job properly. Staff were confident people received good care and knew the people they were supporting very well.

People got opportunity to comment on the service and knew who to talk to if they wanted to discuss their care or raise a concern. The management team were familiar with people’s individual care packages and knew people who used the service and staff very well.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provider to take at the end of this report.