Archived: Nurseplus UK - Fellowes Court

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 and younger adults and children. People could have a range of needs including living with dementia, mental health diagnosis, substance misuse history, physical disability and/or sensory impairment. The service is also registered with us to provide nursing care (Treatment of disease, disorder or injury) but this was not active at the time of the inspection and the service was not employing nurses. The registered manager advised that the service has struggled to recruit and retain nurses but does not want to remove the possibility of doing so in the future. Nurseplus UK- Fellowes Court provided personal care to 131 people when we inspected.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of at least good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

The feedback from people described the service in Good terms. In respect of how caring the service was, the service was described in terms that mean we have judged it to be outstanding. People regularly told us about how “excellent” the service was and the staff were “wonderful” and “lovely”. Everyone felt they were special to and had a special relationship with their dedicated carers. People also felt the service was very professional in all their dealings with them and responded fully to any concerns they had. Comments typically included, “They are brilliant; wish I had them more often. They truly look after me and provide whatever I need”; “They sit and chat and just light up my day. They make me a drink or something to eat; I could not ask for better care”; “A human person to chat with each day allows me to discuss all manner of things, news, sport, our families, the weather. It’s so nice” and, “My carer knows where everything is and does everything for me. It is so nice to see the same face; I enjoy her company and our friendship.”

From initial assessment, through care reviews and in the day to day, we saw people mattered to Nurseplus- Fellowes Court 24 hours a day; not just for the hours they were contracted for. Responding to people’s urgent need at any time of the day and night was seen as a natural part of the job. For one person, we observed this meant every effort was made to reassure them in the early hours and meet their emotional needs at a time of crises. The following day every effort was made to ensure that person had the required support to get through a very difficult time.

The leadership and governance of the service was based on clear values set by the provider. Staff were recruited that put these values into action. The provider and registered manager monitored the quality of the service and people’s care to ensure the values were integral to how people experienced the service.

People confirmed they could communicate with the office directly if they had any concerns, complaints or wished to contribute to their care plan or the way the service was provided to them. They were happy and stated that they could work directly with their care worker who they had become familiar with, struck up a bond and maintained a friendly but still professional relationship. This allowed people to be more open and honest with their care worker. One person said, “Any problems, I can and do call the office who are always very helpful and nice. This is very rare as I am more than happy with my carer; she is so good and helpful. I could not honestly manage without her help, I am very grateful” and another, “My carer is great at resolving my issues and helping me with my daily requirements. He works very hard when he is here and always remains for the allocated time but never appears rushed.”

Staff confirmed they felt the service was safe and very well managed and they enjoyed their working environment with the organisation. They reported they felt important to the provider and registered manager. They were also confident they were supported fully if they had any domestic, personal or work-related issues. Staff told us, “The working atmosphere and culture is so much better than where I have been previously”; “The other staff are great and there is always laughter in the office” and, “I am happy and enjoy my work with the clients and I feel we have a good team of workers.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were partners in deciding, planning and reviewing their care and how to manage any risks. Where it was not possible for them to consent and be involved, key family and professionals were involved in planning what was in people’s best interests.

Staff were recruited safely and in the right number to ensure people’s care could be personalised and at a time they desired. Staff were supported by the ethos of the service to get to know people and spend time with them. Care was not rushed and staff had time to spend with people supporting them to feel less socially isolated. Everyone we spoke with looked forward to their care workers coming and spending time with them. All staff were described as polite, respectful and ensured people’s dignity was protected.

People were assured that staff had the training and skills to meet their individual needs. Staff were trained to a good standard and supported to gain higher qualifications in care. There was an open door and phone policy for all staff. Formal supervisions took place and there were plenty of opportunities to seek additional guidance, support and further training as needed. One person said what others did when they said, “The staff are nice and well trained.”

Where staff were responsible for people’s medicines, food and drinks, these needs were met fully and safely. People were supported to be healthy in their lives or see relevant medical staff as needed. People felt staff would act if they felt they were unwell or unsafe at home; this would be with consent or as a duty of care matter if needed.

The service provided planned, personalised and pain free care to people at the end of their lives. The service was accredited by the local hospice. They were also accredited to look after people living with dementia.

Further information is in the detailed findings below.

Nurse Plus and Carer Plus UK Ltd provide a personal care service to people living in their own home. On the day of the inspection 49 people were supported by Nurse Plus and Carer Plus UK Ltd with their personal care needs.

The service had 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.

During the inspection staff within the office were relaxed, there was a calm and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were clear and easy to follow.

People spoke well of the care and support they received, comments included, “The carers are great, very nice people, wonderful; really good”, “I’m very happy, the staff are very caring, polite and courteous” and “The carers are all very friendly, they help me a lot”. Care records were personalised and gave people control over all aspects of their lives. People’s preferences were identified and respected. Staff responded quickly to people’s change in needs. People were involved in reviewing their needs and expressed how they would like to be supported and by whom.

People were supported by staff who valued the caring role they held. Staff showed a kind and compassionate attitude towards people. Relationships had been developed and staff had an appreciation of how to respect people’s individual needs around their privacy and dignity.

People’s risks were managed well. People were promoted to live full and active lives. People were supported to have as much control and independence as possible.

People had their medicines managed safely. People were supported to maintain good health through regular access to health and social care professionals, such as speech and language therapists, GPs and district nurses.

People felt safe. Comments included, “The carers make me feel safe, they are wonderful” and “I feel safe having the carers present, it gives me a sense of comfort”. Staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff felt confident any incidents or allegations would be fully investigated.

People were supported by staff who made use of their knowledge of the Mental Capacity Act (2005), to make sure people were involved in decisions about their care and their human and legal rights were respected.

People were supported by staff who had received a thorough induction programme and on-going training to develop their knowledge and skills.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.

People knew how to raise concerns and make complaints. People and their relatives who had raised concerns confirmed they had been dealt with promptly and satisfactorily.

Staff described the management to be supportive and approachable. Staff talked positively about their jobs. Comments included, “I love it, it’s the longest job I’ve ever stayed in which says it all for me, I just love it”, “They show their appreciation of the hard work we do, you get praised when it’s appropriate and that motivates me” and “I absolutely love my job, it’s so rewarding. The manager can be so thoughtful; I’ve even been given a voucher when I helped cover sickness. They never forget to say thank you”.

There were quality assurance systems in place to drive continuous improvement within the service. Audits were carried out and where shortfalls in the service had been highlighted, action had been taken to resolve the issues and help ensure quality of care was not compromised.