Fosse Healthcare - Nottinghamshire

Updated 30 October 2020

The inspection

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.

Inspection team

The inspection was carried out by two inspectors, two assistant inspectors and an Expert 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave the provider 48 hours’ notice of the inspection. This was because we wanted to ensure the provider could provide a safe environment for their staff and our inspectors to work whilst adhering to COVID-19 safety precautions and guidelines.

Inspection activity started on 10 September 2020 and ended on 18 September 2020. We visited the office location on 10 September 2020.

What we did before the inspection

We reviewed information we had received about the service since registration. We sought feedback from the local authority and Healthwatch. 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 the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with 33 people who used the service or their relatives about their experience of the care provided to them or their family members. We spoke with four members of the care staff, the registered manager, the managing director and the nominated individual. 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 seven people’s care records, medication administration records and the daily notes recorded by care staff. We looked at a variety of records relating to the care people received and the management of the service, including policies and procedures and training records.

After the inspection

We asked the registered manager to provide us with a variety of policies and procedures and additional information. All information was sent within the required timeframe. We used all this information to help form our judgements detailed within this report.

Updated 30 October 2020

About the service

Fosse Healthcare - Nottinghamshire is a domiciliary home care service providing personal care to adults with personal care needs. Fosse Healthcare - Nottinghamshire were providing a service to 196 people 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 felt safe when staff cared for them in their homes. Some did raise concerns about punctuality of calls and consistency of staff teams. The provider had acted to address this, and records showed most calls were completed on time; however, this was not translated into positive feedback from all people.

Efforts had been made to have a more robust and effective approach to investigation of safeguarding incidents. The provider was currently working with the Local Authority in relation to current safeguarding cases. The outcome of these is not yet known. We will continue to monitor this.

Improvements had been made to the overall assessment of risk; including the risks associated with people’s health and safety. Staff were recruited safely. People’s medicines were well managed. Accidents and incidents were appropriately investigated. Robust infection control procedures were in place. This included how to reduce the risk of the spread of COVID-19.

People’s physical, mental health and social needs were assessed and met in line with current legislation and best practice guidelines. Staff were well trained, and their practice was regularly assessed to aid development and improve the quality of support people received. People were supported to lead a healthy and balanced lifestyle with risks to people’s dietary needs assessed and acted on. The provider had effective relationships with external health and social care organisations and people’s health was regularly monitored. 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 support this practice.

Improvements had been made to the overall governance of this service. Stable management was now in place; the registered manager was supported by the nominated individual to continually improve the quality of the care people received. The registered manager had a good understanding of the regulatory requirements of their role. People’s experiences had improved since the last inspection, although some did still raise some concerns which have been referred to in other parts of this report.

The provider had acted to try to provide a more person-centred and inclusive approach to care. A ‘family provider portal’ enabled relatives to view their family member’s care records and to raise concerns if needed. People felt especially well supported during the height of the COVID-19 pandemic. Staff wellbeing was actively supported and monitored.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 August 2019). There was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 26-28 June 2020. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Safe, Effective and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires Improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fosse Healthcare Nottinghamshire on our website at www.cqc.org.uk.

Follow up

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.