Archived: NK Care

We inspected the service in response to information we had received regarding services being withdrawn from a person.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.

NK Care Limited is registered to provide personal care to people living with dementia, a learning disability or autistic spectrum disorder, mental health, older people, physical disability, sensory impairment and younger adults in their own homes. At the time of our inspection seven people were in receipt of care from the provider.

People who used the service and relatives told us, they were very happy with the care they received and felt safe. Detailed risk assessments had been completed that ensured that staff were aware of individual risks and how to reduce these, in order to protect people from harm. Staff were able to describe in detail the needs of people they supported and how to support people’s safety from potential abuse or neglect. Medicines were safely administered. People told us, they were happy with the support they received with their medicines when required.

Environmental risks were assessed and any identified hazards to people who used the service and staff were reduced as far as possible. Staff were provided with the knowledge and equipment to reduce the risks of the spread of infections.

People told us, they were supported by regular consistent staff. There was a robust system for recruitment in place that ensured staff were suitable for the role for which they were employed.

People who used the service and relatives were very confident in the knowledge and skills of the staff team. The provider demonstrated a training programme was in place that would equip staff with the skills to deliver good care.

Staff supported people to access Health and social care professionals when required to support and maintain their health and wellbeing.

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. Staff demonstrated their understanding of the Mental Capacity Act 2005 (MCA) and its relation to protecting people who used the service from unlawful restrictions. Records confirmed consent was sought for a variety of decisions in relation to the care people received. This confirmed people who used the service or their relatives had been consulted about and agreed to the care they received.

People told us, they were treated with dignity and respect by the staff who supported them. Care plans detailed how people liked or disliked their care to be delivered.Changes in people’s needs were reviewed so they continued to receive care which was responsive to each person’s needs.

We saw extremely positive feedback about the service and the care people received. Any complaints received had been dealt with promptly and brought to a satisfactory conclusion.

All the people we spoke with were extremely complimentary about the leadership and management of the service. Audits, quality monitoring and feedback was obtained regularly that confirmed the quality of service being provided to people.