The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Nursing Relief Agency

Overall: Good read more about inspection ratings

Abbotsbury House, 156 Upper New Walk, Leicester, Leicestershire, LE1 7QA (0116) 212 6704

Provided and run by:
Fortiz Ltd

All Inspections

18 December 2014

During a routine inspection

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.

28 February 2014

During an inspection in response to concerns

During our inspection we spoke with eight people who used the service and their representatives, three care workers, two office staff and the registered manager. We also looked at a number of records including people’s personal records, staff records and records in relation to the management of the service.

People we spoke with were satisfied with the care and support they received from their care workers. People told us that care workers treated them with dignity and respect and they were comfortable allowing care workers into their homes. Many people told us there were issues with care workers timekeeping.

We looked at the records of four people who used the service and found that care had been planned and delivered in a way that promoted people’s health and welfare.

We found that care workers had been appropriately screened to ensure they were suitable to work with vulnerable adults. Care workers we spoke with demonstrated a good understanding of the needs of people who used the service and were positive about their role. However, we found that there were insufficient care workers to be able to consistently meet the needs of people who used the service at an appropriate time. The registered manager told us they were in the process of recruiting staff.

The service did not have an effective and appropriate quality assurance system in place that monitored and assessed the quality of service provided and protected people who used the service from risk.

8 April 2013

During a routine inspection

People told us that the care they received was appropriate. People also told us how much they were reassured by the improvements made over the past few months.

We found the provider had addressed all of our earlier concerns and recognised how this had improved care for people who used the service and the morale and performance of staff. The provider is now working in a co-ordinated manner with external health professionals and commissioners and maintaining comprehensive records. Care records are now suitable and the improved staff management initiatives better meet the needs of people using the service.

26 November 2012

During a routine inspection

People told us that care staff were frequently late and failed to explain the reasons for this. They also told us they were not confident some care staff fully understood their needs and because of this had concerns regarding the quality of care they received.

We found evidence of poor record keeping and inadequate care plans. The care plans we saw did not accurately record people's views and choices nor did the plans contain appropriate needs assessments or associated assessments of risk. Within all the care plans we viewed we found no evidence of daily interventions being recorded or of external health professionals being involved in people's care.

The staff we spoke with were unable to provide us with suitable assurance of them understanding their responsibilities to ensure people received safe and appropriate care. This supported the concerns raised by people using the service that some care staff did not fully understand people's care needs.

Following an earlier inspection we had required the provider to address concerns; during this recent inspection we did not find any evidence of the provider carrying out any improvements to address our earlier concerns.

15 March 2012

During an inspection in response to concerns

We spoke with two people using the service and one carer. Comments varied. One said, 'They're very good.' Another told us, 'Definitely wouldn't recommend them.'

When we asked people if they had been involved in deciding what was in their support plan, people were unsure. One person said, "Up to a point,". Another said they thought they had been involved. One person told us they had not been given a written support plan until some time after they started using the service.

When we asked people if the provider had made any adjustments to meet their individual needs, on person remembered that they had specifically been asked about any cultural needs. Another person said they had never been asked about their diversity.