Inter-County Nursing & Care Services Rustington - Chichester

Updated 5 March 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Inspection team: One inspector and an expert by experience carried out this 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. The expert had personal experience of supporting older people living with dementia who used community services.

Service and service type: This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults. Not everyone using Inter-County Nursing and Care Services: Rustington, receives regulated activity. Care Quality Commission [CQC] only inspects the service being received by people provided with ‘personal care’ such as help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

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 service 24 hours’ notice of the inspection visit because it is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. This inspection took place on the 29 November and 3 December 2018.

Inspection site visit activity included a visit to the office location on 29 November 2018 to see the registered manager and office staff; and to review care records and policies and procedures. We visited people in their own homes on 3 December 2018.

What we did: We reviewed information we had received about the service. This included details about incidents the provider must notify us about. We sought feedback from the local authority and health professionals who worked with the service. Due to technical problems, we did not ask the provider to complete a Provider Information Return [PIR] on this occasion. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

Before, during and following the inspection we reviewed and spoke with;

• Three people, their care records and risk assessments

• Four staff, including their recruitment, training and supervision records

• Records of accidents, incidents, complaints and compliments

• Audits, quality assurance reports and surveys [including those prepared by health commissioners]

•Observed and spoke with five care staff while they provided support to two people in their homes

• Spoke with the registered manager, quality assurance manager, a senior care supervisor and five care staff

• Spoke with ten people using the service and four relatives

• We also spoke with a West Sussex County Council contracts officer and a specialist palliative care nurse from a local hospice

Updated 5 March 2019

About the service: Inter-County Nursing and Care Services Rustington provides care and support to older people living in their own homes. At the time of this inspection 70 people were being supported with their personal care needs.

People’s experience of using this service:

Without exception people and their relatives said that the service provided by Inter-county nursing and care services, Rustington was of an exceptionally high standard. People were extremely confident with the service and spoke very highly about how well the agency was managed by a dedicated registered manager and team of very caring staff.

We reviewed 'five-star' reviews left on an NHS website by relatives of people who had received a service of, “Efficiency with professional care and compassion” from “Excellent staff.". Consistently positive feedback was provided by relatives which demonstrated people were cared for deeply by genuinely kind and compassionate staff who were totally dedicated and committed to ensuring that people received the care they needed and wanted.

People and their relatives said how the agency was responsive to their individual circumstances and situations which gave them reassurance and peace of mind that their loved ones were well cared for. End of life care was provided in a deeply compassionate and gentle way by staff who cared. Relatives said they would “highly recommend” the agency to others. One relative said, “They [staff] have the knowledge of years of experience to advise what is needed without being overbearing and also they care which is what anyone wants when someone you love is not well. I can highly recommend.”

People received very personalised care and support from a very dedicated and reliable workforce who were led by a very professional and competent management team. The registered manager consistently went above and beyond to provide a service that was centered around the needs of people. They maintained their professional knowledge and commitment to people and had received an award to recognise this level of commitment and dedication.

Staff demonstrated a depth of compassion and empathy and genuinely cared for people they supported. People felt they mattered. Positive relationships were developed between staff and people, with people saying they always felt respected by staff and that their privacy and dignity were maintained.

The service was safe, with systems and processes which ensured that any concerns were reported to appropriate authorities without delay.

A personalised approach was evident, with the management and staff team ensuring that people received the care they needed and wanted that met their expectations and preferences.

Staff were well trained and competent in their roles.

People had enough to eat and drink. Staff provided support as required to ensure that people's dietary needs were met.

People had access to health and social care services as needed. The staff and management team provided strong support and worked openly and professionally with external professionals which supported people to receive a coordinated and consistent service.

Rating at last inspection: Good [Last inspection report published 30 December 2015].

Why we inspected: We completed a planned inspection based on the previous rating of Good.

Follow up: We will review the service in line with our methodology for 'Good / Outstanding' services.