Background to this inspection
Updated
25 January 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.
The inspection was undertaken by one inspector, took place on 26, 28, 29 September and 5 October 2015 and was announced. The provider was given a week’s notice because the location was a domiciliary care agency and we needed to be sure that someone would be in. We also gave notice to enable the agency to arrange home visits with people’s consent.
Before the inspection we reviewed information we held about the service. This included previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law.
During the inspection we spoke with the registered manager and five members of staff. We also spoke with one relative, one social care professional, a community matron and a mental health support worker. Following the inspection we contacted the continuing healthcare team and the motor neurone disease (MND) professionals involved in people’s care. We reviewed feedback from the clinical commissioning group and other health professionals.
Newcross supports adults and children in their own home. We visited one adult and three young people with complex care needs in their own home and spoke with the registered manager about other people the agency supported. Some people we met were unable to talk with us so we spoke with people who cared for them. We looked at three records related to people’s individual care needs. These records included support plans, risk assessments and daily monitoring records. We also looked at staff recruitment files and records associated with the management of the service, including quality audits.
Updated
25 January 2016
The inspection took place on 26, 28, 29 September and 5 October 2015 and was announced. The provider was given notice because the location was a domiciliary care agency and we needed to be sure that someone would be in. We also gave notice to enable the agency to arrange home visits with people’s consent.
Newcross Healthcare Solutions Limited (Plymouth) provides a personal and nursing care service to people living in their own home. On the day of the inspection 13 people were supported by the agency with personal care and / or nursing care.
The service had a registered manager 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.
Care records contained information that described what staff needed to do to provide personalised care and support. Staff responded quickly to people’s change in needs. Where appropriate friends, relatives and health and social care professionals were involved in identifying people’s needs. People’s preferences, life histories, disabilities and abilities were taken into account, communicated and recorded.
People’s risks were managed well and monitored. Professionals and families confirmed people were safe and well looked after. Policies and procedures were in place and understood by staff to help protect people and keep them safe.
People were encouraged and supported to maintain a healthy balanced diet. Staff had received specialised training to support people who had complex dietary needs.
People had their medicines managed safely and received their medicines as prescribed. Staff had received specialised training to support people have their medicines when they were unable to have these orally.
People, friends, relatives and staff were encouraged to be involved and help drive continuous improvements. The registered manager regular met with families and professionals to ensure they were happy with the care being provided. This helped ensure positive progress was made in the delivery of care and support provided by the service.
The service sought feedback from people and encouraged people to share their concerns and complaints. The registered manager confirmed that complaints were investigated thoroughly and the outcome would be used as an opportunity for learning to take place.
People were kept safe and protected from discrimination. All staff had undertaken training on safeguarding from abuse and equality and diversity. Staff displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm.
Staff had received appropriate training in the Mental Capacity Act. Staff displayed a good understanding of the requirements of the act, which had been followed in practice.
There were sufficient staff to meet people’s needs. People we met had bespoke packages of care and staff. Staff were appropriately trained and had the correct skills to carry out their roles effectively. Health professionals confirmed “Carers are individually trained and skilled in more complex areas of care, such as care of PEG, tracheostomy care, non-invasive suction and end of life care” and “I am very impressed with the skills staff have. They had managed a young, fully ventilated patient at home for several years, dealing with all aspects of his tracheostomy, poor communication, total lack of movement and all the emotional and social aspects of his life.”
The service followed safe recruitment practices to help ensure staff were suitable to work with vulnerable adults. An induction, regular supervision and competency checks supported staff and helped ensure a high quality of care was provided. Staff described the management as very open, supportive and approachable. Staff talked positively about their jobs and felt motivated to provide quality care.
There were excellent quality assurance systems in place to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service. Information technology was used to make care more individualised and keep staff abreast of changes within the organisation and current research. Feedback from professionals about the leadership at Newcross was outstanding “Exceptionally good management. I often ring (X), the registered manager to discuss issues about patients and how we might address them. She has always looked to do the best for our motor neurone disease (MND) patients. She fully appreciates their complexity.”