Newdon Care Services Limited

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

The inspection took place on 6 June 2018 with the registered provider being given short notice of the visit to the office, in line with our current methodology for inspecting domiciliary care agencies. At our previous inspection in June 2017 the service was given an overall rating of ‘Requires Improvement’. Concerns identified included care plans and risk assessments not being up to date and the monitoring and audit processes not identifying the shortfalls we found during the inspection. We asked the registered provider to submit an action plan outlining how they were going to address the shortfalls we found, which they did.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Newdon Care Service Limited’ on our website at www.cqc.org.uk’.

At this inspection we found improvements had been made regarding care plans and risk assessment updates, and the governance of the service was more robust.

People’s needs had been assessed before their care package commenced and where possible they, or their relatives, had been involved in formulating care plans. Care plans provided satisfactory information and guidance to staff, which assisted them to deliver the care people needed, in the way they preferred. We found care plans and risk assessments had been updated in a timely manner and staff were clear about their role in ensuring care plans reflected people’s current needs.

The system for assessing if staff were following company policies had been improved so shortfalls were identified in a timely manner and addressed promptly. However, these needed to be fully embedded into practice and reviewed to make sure they continued to be effective.

Improvements had also been made regarding how people were consulted about their satisfaction in the service they received and the outcomes of surveys had been shared with them. This meant people knew what action the registered provider had taken to address any areas for improvement.

The majority of the people we spoke with were happy with the quality of the care the service provided and how it was run. They said care workers met their needs and delivered their care as they wanted it delivering. People told us their privacy and dignity was respected and staff were competent in their work, kind, friendly and helpful.

There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. Concerns, complaints, incidents and accidents were being effectively investigated and monitored. This aimed to reduce risks to people and make sure they received the standard of care they expected.

Recruitment processes helped the employer make safer recruitment decisions when employing staff. Staff had undertaken a structured induction, essential training and received regular support, to help develop their knowledge and skills so they could effectively meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Records showed people had consented to their planned care and staff understood the importance of gaining people’s consent and acting in their best interest.

Where possible, people were encouraged to manage their own medication, with some people being supported by relatives. Where assistance was required support was provided by staff who had been trained to carry out this role. However, medication records were not always consistently completed.

The complaints policy was provided to people using the service along with other information about how the service intended to operate. The people we spoke with told us they would feel comfortable raising concerns, if they had any. When concerns had been raised we saw the correct procedure had been used to record, investigate and resolve issues.

Further information is in the detailed findings below.

Newdon Care Services Limited is registered to provide personal care. Support is provided to people in their own homes.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

Information in care plans and risk assessments was not always updated when a person’s needs changed. This meant people could be at risk of inappropriate care and support that did not meet their current needs.

The majority of people told us they felt safe in the care of the staff and staff had a good understanding of abuse and their responsibilities in keeping people safe.

Our observations evidenced there were enough staff on duty to meet people’s individual needs.

Checks were carried out prior to staff being offered a job at the agency which helped to ensure people being employed were of good character.

Staff spoken with told us they felt very well supported by the registered manager at the service. They said they were able to speak with them at any time to ask for assistance or advice. We saw there was a policy in place for the formal supervision of staff; however records of supervisions and appraisals with staff had not always been recorded.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and the principles of the Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

In the main people spoke positively about the care and support they received from the care workers.

Staff respected the right to confidentiality for people who used the service. The service user guide described how people’s confidentiality was kept.

Most people told us they could talk to their care workers and the office staff at Newdon care Services. They said if they had any concerns or worries they were confident staff would listen to them and look at ways of resolving their issues. Some people said they had not received feedback about what was done in response to them raising a concern.

The registered provider and registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks and care reviews. We found these had not been effective in ensuring compliance with regulations and identifying areas requiring improvement and acting on them.

We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in regulation 12: Safe care and treatment and regulation 17: Good governance.

You can see what action we told the provider to take at the back of the full version of the report.