Background to this inspection
Updated
29 April 2023
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was undertaken by one inspector and an Expert by Experience. 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
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
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
This inspection was announced. We gave notice of the inspection as we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 14 March and ended on 21 March 2023. We visited the location’s office on the 16 and the 21 March 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan our inspection.
During the inspection
We spoke with the registered manager, regional manager, two team leaders, and an office administrator. We reviewed various electronic records relating to 10 people’s support and care plans including risk assessments and medicines administration charts. We looked at two staff files in relation to recruitment, staff training and supervision records. We also reviewed systems relating to the management of the service such as the providers action plan, audits and rostering system.
As part of this inspection, we also contacted 21 staff and managed to gain views from seven. We emailed six health and social care professionals and gained feedback from one. Views were gained from six people and eight relatives about their care experience.
Updated
29 April 2023
About the service
Nobilis Care South Gloucestershire is a domiciliary care agency that provides personal care and support to people who live in their own home. At the time of the inspection there were 127 who were receiving personal care.
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
Some people and staff raised with us they were unhappy with the response they received when they called the office as they felt calls were not always handled satisfactorily. They also felt improvements were needed to visit times and rotas. The registered manager confirmed following our inspection this was an on-going area of improvement and they were taking action to address this.
People felt supported by staff who they described as kind and caring. Although improvements were required to people’s care and support plans, risk assessments and other important information was available for staff such as life histories, hobbies and any interests. Improvements were also required to paperwork where people might lack capacity, and what decisions had been made in their best interests.
Staff promoted people’s independence and gave them choice and control about their care and support. Staff knew people well including how to support the person with their individual needs. The registered manager worked in partnership with health and social care professionals including safeguarding teams when required.
An action plan was in place that identified areas of improvement including, medicines administration charts, mental capacity assessments, staff training, supervision and appraisals. The registered manager acknowledged our feedback where some care plans required additional information. They planned to address this with a new quality assurance system and an allocated member of staff to oversee this.
Rating at last inspection and update
This service was registered with us on the 26 September 2022, and this is the first inspection.
The last rating for the service under the previous provider was rated as requires improvement. Published on 4 March 2021.
Why we inspected
This inspection was identified for an inspection by the local authority due to the previous rating of requires improvement.
Enforcement and recommendations
We have identified breaches in relation to people’s care plans and records being accurate and complete and their being a robust system in place that identified this shortfall.
Please see the action we have told the provider to take at the end of this report.
We recommend the provider seeks best practice guidance relating to complaints and where people’ might lack metal capacity.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk