Archived: Nursing Relief Agency

Updated 20 April 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 was 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.

The provider was given 48 hours’ notice of the inspection because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available to assist us.

The inspection team consisted of an inspector and an expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service. The inspector visited the offices of the service on 18 December 2014. The expert by experience spent time talking to people who used the service and their relative prior to our visit to the offices.

We spoke with nine people who used the service and their relatives, four care workers, one office staff member and the registered manager. We reviewed a range of records about people’s care and how the service was managed. This included four people’s care plans, four staff records and records in relation to the management of the service.

Prior to our inspection we reviewed the information we held about the provider. We looked at any incidents the service had notified us about and reviewed what had been happening at the service over the last 12 months. We also considered the inspection history of the service.

Before the inspection the provider was asked to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider did not send us the information we requested however during the inspection we established that this was due to a technical matter.

Updated 20 April 2015

We inspected the service on 18 December 2014. The provider had a short amount of notice that an inspection would take place so we could ensure staff would be available to assist us.

The Nursing Relief Agency provides care and support for people living in their own home. At the time of our inspection there were 16 people using the service with a variety of needs. These included older adults, people with physical disabilities and people with dementia care needs.

There was a registered manager in post. 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.

At our previous inspection on 28 February 2014 we found that the provider was not meeting two regulations. These related to the numbers of staff appointed at the service and quality assurance. The provider sent us an action plan outlining how they would make improvements.

We checked for improvements during this inspection and found that the provider had made sufficient improvements to comply with these regulations.

There were sufficient numbers of staff available to ensure people’s needs were being met at an appropriate time.

There were effective systems in place to assess and monitor the quality of the service. This included gathering the views and opinions of people who used the service and monitoring the quality of service provided.

People we spoke with and their relatives told us they were satisfied with the care and support provided. They had developed good relationships with their care workers and told us they were treated with kindness and respect and felt safe using the service. People were confident that any issues or concerns they had would be responded to appropriately by the service.

Staff had a good understanding of the needs of people they cared for and were positive about their role and the organisation.

Staff recruitment procedures were robust and ensured that appropriate checks were carried out before commencing work. Staff received a thorough induction and on-going training to ensure they had up to date knowledge and skills to provide the right support for people. They also received regular supervision, appraisal and observations of their practice.

Staff were complimentary about the registered manager and had no concerns about raising issues.

People’s needs were assessed and plans were in place to meet those needs. People’s wishes and preferences were taken into account, recorded in care plans and respected during care delivery. Risks to people’s health and well-being were identified and plans were in place to manage those risks.

People were supported to access healthcare professionals whenever they needed to and their needs in relation to eating and drinking were supported. People’s medicines were managed and administered safely.

People’s consent had been appropriately obtained and recorded. However, we noted that people’s relatives had at times been asked to consent on people’s behalf when the service had not established that the person lacked capacity to do so. The registered manager understood the principles of the Mental Capacity Act and how they might apply to the people who used the service.