Archived: NK Care

Updated 7 December 2018

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.

The inspection took place on 02 October 2018 and was unannounced. Calls were made to people using the service on 03 October. The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has experience of using or caring for someone who uses this type of care service.

We reviewed information we held about the service. This included information received from the provider about deaths, accidents/incidents and safeguarding alerts which they are required to send us by law. We had requested and received a Provider Information Return, this information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also contacted the local authority to gather their feedback about the service.

We spoke with two people who used the service and three relatives. We also spoke with one member of care staff, the acting manager and the provider on 08 October by telephone.

We looked at the care records for five people, alongside three medication records. We also looked at three staff recruitment files, staff training information and records held in relation to quality assurance and the organisation of the service.

Updated 7 December 2018

This inspection took place on 02 October 2018 and was an announced inspection with the provider being given 48 hours’ notice to enable any staff available to be present. Calls were made to people using the service on 03 October and a telephone conversation was held with the provider on 08 October as they had been unavailable at the time of the inspection.

We inspected the service in response to information we had received regarding services being withdrawn from a person. During the inspection we looked into this concern.

This service was last inspected on 06 December 2017 where it was rated as Good. At this inspection the rating had changed to Requires Improvement overall, with Requires Improvement within the domains of Safe, Effective, Responsive and Well Led.

NK Care Services is a domiciliary care agency. It provides personal care to younger and older adults living in their own homes who may have a learning disability, mental health condition, eating disorder, substance misuse problems, physical disability, sensory disability or dementia. On the day of the inspection eight people were receiving support.

NK Care Services is required to have 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 a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of inspection there was an acting manager in place. The acting manager told us that they were about to begin the process of becoming the registered manager.

We found that risk assessments were not always in place in order to mitigate any risk to people. The recruitment and retention of staff had been problematic for the provider. Whilst recruitment processes were completed as required, where further consideration was required in relation to references provided this was not always carried out. Medicines were given appropriately and recorded correctly. People felt safe in the care of staff members and praised the care they received.

People were not always confident that staff knew their needs. Staff did not consistently receive an effective induction and there was a lack of evidence that training was ongoing or appropriate. People were supported to eat and drink adequately. Staff gained consent from people prior to carrying out care and made people aware of the actions they were to take.

Staff were kind and caring towards people and positive relationships had been formed. Staff enabled people to be independent and to make choices where possible. People’s privacy and dignity needs were maintained by staff members caring for them.

Care plans were in place, but did not always provide detailed information on people’s needs. The cultural needs of people were acknowledged. People knew how to make complaints and were satisfied they were dealt with appropriately.

Audits did not always discover issues that required attention and were not carried out regularly. Due to the time restraints placed on the acting manager there was considerable gaps within recordings and checks on staff’s competency. Feedback had not been taken from people and we saw no evidence that staff were able to voice any opinions or views. The manager knew people well. Notifications of incidents were received as required.