3 March 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection consisted of one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a new manager who was in the process of being registered with the Care Quality Commission. This means that they and the provider would be legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 5 February 2020 and ended on 14 February 2020. We visited the office location on 7 February 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with six people who used the service and six relatives about their experience of the care provided. We spoke with eleven members of staff including the nominated individual, manager, office staff, senior care workers, and care workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one health care professionals who regularly worked alongside staff and contacted via email two other health professionals to request feedback.
3 March 2020
About the service
Nationwide Care Services LTD (Worcester) is a domiciliary care service providing personal to 62 people living in the community at the time of the inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People were supported by staff who understood how to keep people safe and protect them from the risk of avoidable harm. People had skilled staff available to meet their needs. People’s risks were assessed, and staff understood the plans in place to guide staff. Staff followed safe systems for management of medicines when people needed support with this. People were protected from the risk of infection through staff following best practice infection control and prevention procedures. Systems were in place to investigate incidents and accidents to ensure lessons were learnt.
People's needs were assessed, and care was planned to meet legislation and good practice guidance. People were supported by staff who were trained and knowledgeable about people's needs and wishes. People had support with their meals as part of their identified needs. People were supported with accessing health care if needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service were being implemented to support this practice.
People were cared for by staff who treated them as individuals and up held their rights. Staff were kind and compassionate towards people and they enjoyed their company. People and their relatives felt involved and supported in decision making. People's dignity was respected, and their privacy maintained.
People and their relatives were positive about the service and the care provided. Staff had the information they needed to provide personalised support. People's concerns were listened to and changes made to improve the service. When people needed support at the end of their life staff were skilled and there were systems in place to provide quality support.
The manager and staff were open, approachable and it was important for them to provide quality care. People knew staff and the manager well and benefitted from good communication with them. People were supported by staff who were regularly monitored to ensure they provided quality care. Staff and the management team established good relationships with other professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 2 August 2017)
Why we inspected
This was a planned inspection based on the previous rating.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.