25 January 2024
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 Health and Social Care Act 2008.
The inspection was carried out by 1 inspector and 2 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was not a registered manager in post. The provider had recruited a new manager who was due to start work shortly.
Notice of inspection
We gave the service 2 days’ notice of the inspection. This was because we needed to be sure that the provider would be in the office to support the inspection.
What we did before the inspection
We reviewed information from the local authority commissioning team. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.
During the inspection
Inspection activity started on 8 December 2023 and ended on 28 December 2023. Phone calls were made to people and relatives on 8 and 11 December 2023. We visited the location’s office on 14 December 2023.
We spoke with 6 people and 9 relatives of people who used the service. We spoke with 8 staff in total, including the nominated individual, 2 area managers and 5 care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed the relevant parts of 5 people's care plans and 3 people’s medicines records. We looked at audits, policies, training records and 3 staff recruitment files.
25 January 2024
About the service
Nationwide Care Services Limited (Derby) is a domiciliary care agency. The service provides personal care to a range of people including people living with dementia, learning disability and or autism needs and mental health needs. At the time of our inspection there were 134 people using the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of the key questions, safe and well-led the service was able to demonstrate how they were meeting underpinning principles of “Right Support, Right Care, Right Culture.”
Right support: 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 supported this practice.
Right care: People’s care needs had been assessed with risks identified and actions taken to reduce these. People received safe care and the provider checked to ensure staff were suitable to work at the service. Medicines were managed in line with good practice.
Right culture: The service worked to provide people with person-centred care and involved them in their care decisions. The provider looked to continuously learn and improve people’s care and actively monitored the quality and safety of care.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good (published 23 October 2020).
Why we inspected
We received concerns in relation to the care people received. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has not changed following this inspection. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Nationwide Care Services Limited (Derby) on our website at www.cqc.org.uk.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.