We carried out a review of the data available to us about Day and Nightcare Assistance (HO) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Day and Nightcare Assistance (HO), you can give feedback on this service.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people, people living with dementia and people with physical disabilities. There were 209 people using the service at the time of the inspection.
Not everyone using Day and Nightcare Assistance receives regulated activity; the CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
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 the last inspection on 25 April 2016, the service had been rated ‘good’. At this inspection we found the service remained ‘good’.
The service ensured people were safe. Risks to people had been identified, assessed and were managed safely. Staff were aware of their responsibilities and knew how to identify and report abuse. Medicines were administered safely. The registered provider followed safe and robust recruitment procedures. There were sufficient numbers of staff to support people safely.
People received effective care. Staff were supported to undertake training needed for their professional development, including nationally recognised qualifications. Staff received regular supervisions and appraisals which enabled them to develop their understanding of good practice and to fulfil their roles effectively.
Where some people were unable to make certain decisions about their care, the legal requirements of the Mental Capacity Act 2005 were followed. People were supported to have their health needs met by health and social care professionals, including their GP and dietitian. People were offered a healthy balanced diet and when people required support to eat and drink, this was provided in line with relevant professionals’ guidance.
The service continued to provide support in a caring way. Staff protected people's privacy and dignity and treated them with respect. People had developed positive relationships with staff and were treated in a caring and respectful manner. People were supported to be as independent as they possibly could be.
The service continued to be responsive to people's needs and ensured people were supported in a personalised way. Any changes in people's needs were addressed immediately. People and their relatives were aware of how to make a complaint. When concerns had been raised, they had been dealt with in line with the provider’s complaints policy and procedures.
The service was led by the registered manager who promoted a service that put people at the forefront of all the service did. Staff were valued and supported by the registered manager and the provider. They were given appropriate responsibility which was continuously monitored and checked by the registered manager. A system to monitor, maintain and improve the quality of the service was in place.
Day and Nightcare Assistance provides personal care to elderly and disabled people in their own homes. At the time of our last inspection there were135 people using the service.
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.
People said that they felt safe with the care and support provided, and that staff were kind, caring and always respectful towards them. Staff knew how to recognise signs of abuse and protect people from such harm. They received regular training in how to keep people safe. Staff were not recruited until checks were made to ensure they were suitable to work with people who use the service.
There were procedures and processes in place to ensure the safety of people who use the service. These included risk assessments which identified the ways of minimising the risks to people.
When people required assistance to take their medicines, there were arrangements in place to provide this support safely.
Accidents and incidents were appropriately investigated and recorded with clear details of investigations and actions taken to help prevent re-occurrence.
There were sufficient numbers of properly recruited care workers who had the skills and knowledge to provide care and support to people according to their preferences.
People’s consent was sought when appropriate and the service operated within the requirements of the Mental Capacity Act (2005) (MCA). The service ensured the actions involved in providing care were taken in people’s best interests.
People received support with eating and drinking. The kinds of support varied, dependent on people’s health status, their needs and preferences. Appropriate professional advice was obtained where necessary to ensure people's health needs were supported.
Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported. People were involved in making decisions about their care.
Staff had not hesitated to devote their own time to assist people on day trips or help them to pursue their hobbies. What is significant, their commitment had not been restricted to a singular action. Staff had constantly put a lot of effort into providing care to people, not for benefits, but often at the expense of their own time. For example, they had supported people voluntarily helping them with Christmas shopping.
The registered provider had a compliments and complaints policy and a relevant procedure following the policy. Each person was given a copy of the complaints procedure. People told us that complaints were responded to and resolved. Staff assured us they knew how to complain and that they were confident any complaints would be listened to and acted on.
There was an open and transparent culture in the service. The management team demonstrated effective leadership skills and care workers said they felt valued and supported. Staff understood their roles and responsibilities in providing safe and good quality care to people who use the service.
The provider and the registered manager used systems to measure the safety and quality of the service. Checks and audits were completed regularly to make sure that good standards of care were maintained.
We looked at the care records for five people. We found that information in these records had been used to form a detailed and individualised care plan.
We looked at the training and professional development provided to care workers. We found that care workers had received training and support to ensure that they had the skills to undertake their care tasks appropriately.
People told us that they felt safe when being cared for by care workers. We found that staff knew their responsibility with respect of safeguarding people. The agency acted in accordance with local safeguarding arrangements when abuse was identified or suspected.
We looked at the provider's quality assurance and risk management systems. We found that systems were not in place to enable the manager to effectively identify, monitor and manage risks to the service as a whole. The monitoring of the quality and safety of services provided to people was not taking place through for example, internal auditing procedures. We concluded that the provider did not have an effective system in place to regularly assess and monitor the quality of service that people received.
We spoke to two people who used the service and one relative. The comments we had included "some of the best carers we have ever had because of the excellent attitude of the carers". "The carers are all very nice and look after me well".
People told us that they had a choice in who provided their care and could request a change if care was not being given in the way they wanted.
People we spoke with told us that their care was regularly reviewed and that if there were problems the manager would look into it personally. People told us that they would be listened to and that action would be taken if they had a complaint.