Top Carers Nursing and Domiciliary Care Agency

Top Carers Nursing and Domiciliary Care Agency is a domiciliary and nursing care service. The service provides personal and nursing care to people living in their own homes. At the time of the inspection four people were receiving personal care and no people received nursing 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. At the time of the inspection some people were receiving support which did not include personal care and the provider also supplied staff to care homes and hospitals. We did not review the care they received as it is outside our regulatory remit.

People’s experience of using this service and what we found

The provider assessed risks to people to ensure staff had clear guidance to follow to reduce these risks. People’s medicines were managed safely and the registered manager carried out frequent checks of this. Staff were well trained in medicines management with assessments to check they were competent. Staff received formal and informal supervision with good recording systems so the provider could check the support staff received. The provider had a good system of audits in place to check people received the right standard of care.

The provider checked staff were suitable to work with people by undertaking the necessary recruitment checks. There were enough staff to support people safely and staff timekeeping was good. Staff followed suitable infection control practices, including the safe use of personal protective equipment (PPE) to reduce the risk of COVID19 transmission, and received training on this.

Staff received suitable training and support on how to meet people’s needs. People were supported to maintain their health and staff were trained to meet people’s specific needs. People received food and drink of their choice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were caring and developed good relationships with people. People were supported to maintain and improve their independent living skills where this was an agreed part of their care. People received consistency of care from staff who knew them well. Staff treated people with dignity and respect. People were involved in their care and their care plan was based on their individual needs and preferences. The provider had a suitable complaints procedure in place and relatives had confidence any complaint would be investigated properly.

A registered manager was in post who was supported by a contracts officer and a senior nurse who also trained staff in specialist topics. Staff felt well supported by the management team. The provider engaged well with staff, people and relatives to ensure people received the care they needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

This service was rated requires improvement at our inspection in June 2021 with breaches in safe care and treatment and good governance. We asked the provider to complete an action plan setting out how they would improve. At this inspection we found the provider had improved and was no longer in breach.

Why we inspected

This inspection was prompted to check the provider had followed their action plan and were meeting the regulations.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Top Carers Nursing and Domiciliary Care Agency is a domiciliary and nursing care service. The service provides personal and nursing care to people living in their own homes. At the time of the inspection eight people were receiving personal care and no people received nursing 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. At the time of the inspection some people were receiving support which did not include personal care and the provider also supplied staff to care homes and hospitals. We did not review the care they received as it is outside our regulatory remit.

People’s experience of using this service and what we found

The provider had assessed risks to people to ensure staff had clear guidance to follow when caring for people but assessments relating to medicines management were not sufficiently comprehensive. The provider could not evidence they always checked medicines records regularly to ensure people received their medicines as prescribed. The provider told us they trained and assessed staff as competent to administer medicines but these checks were not always recorded to ensure a clear record of any areas where staff required more support. Staff received regular supervision but this was not recorded to ensure a record of support as required by law. Our inspection findings showed the provider’s system of audits and checks required improvement as they had not identified and resolved the concerns we identified.

The provider checked staff were suitable to work with people through recruitment checks, although they did not always investigate gaps in employment records. There were enough staff to support people safely and staff timekeeping was good. Staff followed suitable infection control practices, including the safe use of personal protective equipment (PPE) to reduce the risk of COVID19 transmission, and received training on this.

Staff received suitable training and support on how to meet people’s needs. People were supported to maintain their health and staff were trained to meet people’s specific needs, such as those relating to epilepsy and breathing equipment. People received food and drink of their choice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives were very positive about the staff who supported them and developed good relationships with them. People received consistency of care from staff who knew them well. Staff treated people with dignity and respect. People were involved in their care and their care plan was based on their individual needs and preferences. The provider had a suitable complaints procedure in place and relatives had confidence any complaint would be investigated properly.

A registered manager was in post who was supported by a contracts officer, office manager and a senior nurse who also trained staff in specialist topics. Staff felt well supported by the management team. Relatives and staff told us the service was well-led and the provider engaged well with them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This service was rated Good at our inspection in March 2015.

Why we inspected

This inspection was prompted because of the length of time since our previous inspection. We needed to check whether the service was meeting people’s needs.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

We reviewed people's care files and found that people's needs were assessed and care and treatment planned and delivered in line with their individual care plan. People's care, treatment and support was planned and delivered to ensure their welfare and safety. People told us they were happy with the way in which care was delivered.

We found that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff received regular training in safeguarding vulnerable adults and had a good knowledge about the types and signs of abuse.

There were effective recruitment and selection processes in place and comprehensive checks were carried out before staff began work. We found that people were cared for by staff who were supported by the service to deliver care and treatment to people safely and to an appropriate standard.