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Nightowls Home Care Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 22 May 2019

During a routine inspection

About the service

Nightowls Home care is a domiciliary care agency which provides personal care to older people living in their own homes within Colchester and Mersea Island.

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

People’s medicines were not always managed safely. People were cared for by staff who had a good understanding of how to keep them safe, however not all individual risks had been identified or recorded to provide guidance to staff. Staff were recruited safely, there were enough staff to meet people’s individual needs and care visits were carried out as required. Systems required further development to ensure that any issues were recorded, learning was identified, and action taken to make improvements.

Staff had received some training to support people effectively, however practical moving and handling and training to meet people’s specific health needs had not been provided. People’s nutritional needs were met, and people’s health was well managed. Staff had links with health professionals which promoted positive outcomes for people. People were actively encouraged to make day to day decisions.

People were cared for by staff who maintained their privacy and dignity. Staff knew people well were kind and compassionate. Positive relationships had been formed between staff and people using the service and people were encouraged to maintain their independence.

People, relatives and staff were positive about the registered manager and how the service was managed. Some concerns raised at the previous inspection had not been addressed. The oversight and governance of the service required review to ensure that any issues were identified and rectified to ensure the service continuously improved.

We have made a recommendation about medicines management, training and the implementation of the Accessible Information Standard.

Rating at last inspection and update

The last rating for this service was requires improvement (published 25 May 2018).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, enough improvement had not been made or sustained and the provider was still in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the second time.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

Inspection carried out on 20 April 2018

During a routine inspection

This was the registered provider’s first inspection since being registered with the Care Quality Commission on 25 June 2015.

Nightowls Home Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service for older adults living within Colchester and Mersea Island. The domiciliary care agency office is situated in Marks Tey and based within the registered provider’s home.

This inspection was undertaken on the 20, 26 and 27 April 2018. At the time of the inspection 33 people were receiving a domiciliary care service from Nightowls Home Care.

The registered provider was also the registered manager. 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.

Staff recruitment practices required significant strengthening as not all records had been sought. Newly employed staff had not received a comprehensive induction and improvements were required to ensure all staff attained up-to-date refresher training and received practical manual handling training.

Effective and robust governance arrangements were not in place to assess and monitor the quality of the service. Quality assurance systems did not identify the issues we found during our inspection to help drive and make all of the necessary improvements required to achieve compliance with the fundamental standards and the registered provider’s own policies and procedures. The fundamental standards are the standards which care provided by the domiciliary care service must not fall below.

Although there was no impact to suggest that people’s care and support needs were not being met, not all risks to people’s health, welfare and safety had been identified and improvements were required to guide staff in the steps they should take to mitigate risks to ensure people’s safety and wellbeing.

Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures. The service was appropriately staffed to meet the needs of people using the service. The management of medicines ensured people’s safety and wellbeing.

Suitable arrangements were in place for staff to receive regular formal supervision. People’s nutritional and hydration needs were met. People received appropriate healthcare support as and when needed and staff knew what to do to summon assistance. The service worked together with other organisations to ensure people received coordinated care and support. People were supported to have choice and control of their lives.

People using the service and those acting on their behalf were very complimentary regarding the service provided. People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported. There was a positive culture within the service that was person-centred, open and inclusive.

Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Information about how to make a complaint was available and people’s representatives told us they were confident to raise issues or concerns.

We have made recommendations about the management of risk and robust inductions for newly appointed staff being in place.

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