Archived: Nationwide Care Services Ltd (Nottingham)

Updated 20 October 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 checked 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 was announced and completed by two inspectors and two experts by experience. The provider was given 3 days’ notice because the location provides a domiciliary care service and we needed to be sure that the registered provider and their staff would be available. The inspection site visit activity started on 19 September and ended on 25 September 2018. It included telephone calls to people using the service and relatives, which were carried out by 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. We visited the office location on 24 September 2018 to speak with the registered manager and office staff; and to review care records and policies and procedures. In addition, the two inspectors visited three people within their own home who received services.

We checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information that we had received from the public. We used this information to formulate our inspection plan.

We also used information the provider sent us in the Provider Information Return. This is 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 spoke by telephone with 25 people who used the service and three relatives. We also spoke with four members of care staff, a senior care staff, the care coordinator, compliance officer, the training manager and the regional manager.

We looked at the care records for nine people to see if they were accurate and up to date. In addition, we looked at audits completed by the service, in relation to reviews and medicine management. We also looked at recruitment folders for three staff. We reviewed some quality audits to ensure the service was continuously monitored and reviewed to drive improvement.

Updated 20 October 2018

The inspection took place between 19 to 25 September 2018 and was announced. At the last inspection we rated the service overall as ‘Requires improvement’ at this inspection we saw the required improvements had been made in safe and effective. Within well led the improvements we required at the last inspection had been made, however other areas of concern were raised in the well led domain.

This service provides care at home to older adults and younger adults living with a range of health conditions and needs to live independently in the community within the Nottingham area. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, 140 people were receiving personal care as part of their care package.

Nationwide Care Services Ltd had not got a registered manager, however, the provider had recruited a manager who was due to commence their role in October 2018. During the managers absence the service had been overseen by the regional 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.

The out of hours service was not always responsive to meet people’s needs in messages being shared or in supporting staff when the office was closed. Communication was not always offered to provide people with information about their weekly calls. Some staffs travel time had an impact on them not being able to meet the required call times.

Staff felt supported by the regional manager and the local office staff. Supervisions and local team meetings provided staff with the support they required for their roles. Partnerships had been developed with health and social care professionals. Complaints had been responded to.

People received support from regular staff or small teams of staff. All staff had received the correct recruitment checks to ensure they were safe to work with people. Staff had received training in how to protect people from harm and how to reduce the risk of infections. Risk assessments had been completed and guidance was provided. Medicine was managed safety and lessons had been learnt when errors had occurred, the changes made had driven improvements.

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 ensured they obtained consent before providing care. Staff had received training for their role and additional training was available to reflect individual needs. People were supported with their meals and followed guidance from health care professionals to support people’s health care needs.

Staff provided regular support to people which had enabled relationships to be developed. People felt able to continue to have a level of independence supported by the staff. Their dignity was maintained and staff showed respect for people. Information was stored to maintain confidentiality and the information detailed the care agreed to be provided.

Care plans had been developed with the people and or relatives. Reviews provided people with the opportunities to share their views in addition to a quality survey. When people’s needs changed the care plans were updated. All information was included which considered people’s religious or sexual needs.