We undertook this announced inspection on 22 November 2018. Standard Nursing Agency and Care Services Limited –Wembley is registered to provide Personal Care services to people in their own homes. The services they provide include personal care, nursing care, housework and assistance with medicines. At this inspection the service was providing care for a total of about 52 people including children and adults. The service also provided nurses for NHS community and hospital services. Their nurses working as temporary staff carry out tasks under the direction of nurse managers either in the community or in hospitals. The agency received feedback on the performance of these nurses via comments made in the time sheets completed by nurse managers. The feedback form received by the agency indicated that the nurses were capable. This was also confirmed by managers of NHS services we contacted.CQC only inspect the service received by people provided with 'personal care' and nursing care; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
At our last inspection on 3 May 2016 the service met all the regulations we looked at and was rated as overall Good.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.
People who used the service and their relatives informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they felt safe when cared for by care workers. There were safeguarding children and adult’s policy and arrangements for protecting children and adults from abuse. The policies had however, not been updated to include guidance to care workers on ensuring that allegations of abuse were promptly reported to the CQC. These were done soon after the inspection.
The service operated under a set of seven core principles of care, which are reflective of the Principles for Good Homecare as outlined by the Equality and Human Rights Commission. These are privacy, dignity, independence, security, rights, choice and diversity and formed a key part of their staff induction training.
People and their relatives informed us that they felt safe with their care workers. Most of the required risk assessments were in place. The care records of two people did not contain appropriate risk assessments in respect of certain aspects of their care. These were prepared soon after the inspection.
There were suitable arrangements for ensuring that people received their medicines as prescribed. Audit arrangements were in place and the no gaps were noted in the Medicine administration records (MAR) we examined.
The service had an infection control policy and people and their relatives stated that care workers observed hygienic practices.
Care workers had been carefully recruited and the required pre-employment checks had been carried out. The service endeavoured to recruit a wide range of care workers from backgrounds that matched the diversity of people who use the service. Where possible, they had responded to requests for care workers who could meet the specific preferences of people. New care workers received a comprehensive induction and training programme to enable them to care effectively for people. Support, supervision and appraisals had been provided by senior staff. There were enough care workers to meet people's needs. Teamwork and communication within the service was good.
People’s healthcare needs were monitored when it was part of the care agreement. Care workers worked well with social and healthcare professionals.
Care workers were helpful and caring in their approach. They listened to people and were aware of the individual needs and preferences of people. The service had a policy on ensuring equality and diversity. People stated that care workers respected their cultural and religious observances.
People’s care needs had been attended to and care workers carried out their duties in accordance with the agreed care plans. There were appropriate and up to date care plans. People and their representatives were involved in care planning. Reviews of care had been carried out with people and those involved to ensure that people received care which met their needs.
The service had a complaints procedure. People knew who to complain to if they had concerns. Complaints made had been promptly responded to.
People who used the service, their relatives and care professionals expressed confidence in the management of the service. Audits and checks of the service had been carried out by the registered manager and senior staff of the company. We noted that these audits and checks were not sufficiently comprehensive as some deficiencies had not been identified and promptly responded to. The service informed us soon after the inspection that action had been taken to improve their checks and audits.