Background to this inspection
Updated
5 September 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 28 and 31 July 2017 and was announced. The provider was given 48 hours’ notice so people who used the service could be told of our visit and asked if they would be happy to talk with us.
It was carried out by two adult social care inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information in the PIR and also looked at other information we held about the service before the inspection visit, including statutory notifications which the provider had sent us. A statutory notification is information about important events which the provider is required to send us by law.
During this inspection we spoke with five people and 32 relatives. We did not visit people in their own homes because they were receiving care at the end of their lives. We contacted six commissioners of care for feedback about the service. We spoke with seven staff, a healthcare assistant, four senior nurses, three clinical nurse managers, the registered manager and also communicated with the HR department by email.
Updated
5 September 2017
This inspection took place on 28 and 31 July 2017. Due to the sensitivity of the care provided by the service, the provider was given 48 hours’ notice of our visit. This was so people who used the service could be told of our visit and asked if they would be happy to talk with us.
Marie Curie is a registered charity which provides end of life care via nine hospices and community nursing across the country. Marie Curie Nursing Service (South West) (shortened to MCNS) is a registered provider of palliative and end of life care services to adults with terminal illnesses across the South West. At the time of our inspection there were 148 people receiving care.
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 were referred to the service by healthcare professionals but the main referrer source was District Nurses. Clinical Commissioning Groups (CCGs) commission the service. Staff worked as an integrated team with other health professionals such as District Nurses and GPs. Most of the care provided for people was nine hour overnight care in their own homes. Relatives told us this meant they could get some sleep at night. Feedback from commissioners was very positive.
Staff knew the people they supported and provided a personalised service. Staff used care plans provided by district nurses detailing how people wished to be supported. District nurses also provided risk assessments for any risks to the person and to the staff supporting them. This included environmental risks and any risks due to the health and support needs of the person.
Everyone told us staff were very caring and they were treated with kindness and compassion. People and their relatives told us staff respected people’s privacy and dignity.
Relatives told us people were kept safe and free from harm. Staff received safeguarding training for both adults and children. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.
Systems, processes and standard operating procedures around medicines were reliable and appropriate to keep people safe. Monitoring the safety of these systems was robust.
People’s capacity to make decisions was assessed and where possible they were supported to make their own choices and decisions. The staff understood their role in relation to the Mental Capacity Act 2005 (MCA).
The registered manager and provider undertook audits to review the quality of the service provided and made the necessary improvements to the service.