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Fosse Healthcare - Nottinghamshire Requires improvement

This service was previously registered at a different address - see old profile


Inspection carried out on 26 June 2019

During a routine inspection

Fosse Healthcare – Nottinghamshire is a domiciliary care agency providing personal care to 301 people across Nottinghamshire. 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 told us they felt safe with staff; however, many raised concerns about staff punctuality and the consistency of staff. Records showed calls were overall made on time and people normally received a consistent team of staff; however, people told us their experiences did not always reflect this.

Risks were assessed in key areas; although, this was not consistently applied across all aspects of care, such as repositioning of people who were at risk of developing pressure sores. Environmental risk assessments were in place, but these did not include reference as to how to make people safe in an emergency.

The provider ensured safeguarding processes were followed. People’s medicines were managed safely. The risk of the spread of infection was safely managed.

The provider had systems in place to help staff to learn from mistakes. We did note that a staff member did not follow care plan and risk assessment guidance when providing care for a person which placed the person’s safety at risk.

Most people received care in line with their assessed needs. There were gaps in some staff training, although there were plans in place to address this.

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.

People received the support they needed to maintain a healthy diet, although guidance was not in place to support people with appropriate foods for a diabetic diet. People had access to other health and social care agencies where needed.

People and relatives found the staff to be caring and respectful. People were treated with dignity when personal care was provided. Independence was encouraged.

People felt involved with decisions and that staff respected their wishes. People’s records were stored securely to protect their privacy.

People’s care records were person-centred and focused on what was important to them. People told us when they received their expected member(s) of staff they always received care in their preferred way.

Complaints were responded to in line with the provider’s complaints policy. People were not currently receiving end of life care. End of life care was to be discussed with people during reviews of their care.

Quality assurance processes were in place; however, these were not always effective in highlighting and addressing the concerns we have raised during this inspection.

Some members of staff had not completed refresher training when needed, this could place people at risk of receiving inappropriate or unsafe care.

People were asked for their views during telephone interviews; however, no analysis was conducted to identify any trends. No annual survey was completed to enable the provider to assess the quality of the service provided for all. This could hinder the opportunity for continued learning and development.

Some people felt office-based staff did not always communicate effectively with them. When people had met the registered manager, they found her to be supportive and approachable. The registered manager had a good understanding of the regulatory requirements of their role

Rating at last inspection and update: The last rating for this service was Good (published 7 March 2017). The service’s rating has now changed to requires improvement.

We have identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. More information about this is in the full report and can also be f

Inspection carried out on 30 January 2017

During a routine inspection

Fosse Healthcare Nottinghamshire provides personal care and support to people who live in their own homes in Nottinghamshire.

We carried out this inspection on 30 January 2017. It was an announced inspection, which meant the provider knew we would be visiting. This was because we wanted to make sure the registered manager, or someone who could act on their behalf, would be available to talk with us.

This was the first inspection of the service since it was registered in August 2015.

A registered manager was 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Some concerns were raised regarding the potential impact of inconsistent timekeeping, late calls and inadequate communication and the associated risk to people’s safety and welfare.

Staff were appropriately recruited, trained and supported. They had undergone a comprehensive induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication was effective and regular meetings were held to discuss issues and share best practice. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

The provider had detailed policies and procedures relating to medicines management. Staff understanding and competency regarding the management of medicines was subject to regular monitoring checks and medicines training was updated appropriately.

Staff knew the people they were supporting and provided a personalised service and used effective systems for gaining consent. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

Systems were in place to effectively monitor the safety and quality of the service and to gather the views and experiences of people and their relatives. The service was flexible and responded positively to people’s changing needs and any issues or concerns raised. People and their relatives told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.

We have made a recommendation regarding the scope and thoroughness of current quality monitoring arrangements