N1C

Updated 10 February 2024

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 Health and Social Care Act 2008.

This service was inspected due to length of time since last inspection. At the last inspection this provider was rated as Good overall and in all areas.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced.

We gave the service 24 hours notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 28th November 2023 and ended on 7th December 2023. We visited the location’s office/service on 28th November 2023.

What we did before

We used the information the provider sent us in the provider information return (PIR). 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 a combination of onsite and off-site evidence gathering for this inspection. In addition to visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.

During the inspection

Whilst on site we looked at all 5 people’s care plans and risk assessments. We looked at 6 staff recruitment and training records. We also reviewed managerial audit files.

After the inspection

Following the site visit we spoke with registered manager about the service. We also spoke to 3 members of staff by telephone along with one person receiving care and one person’s relative.

We reviewed the following policies for the service: health and safety, person-centred care planning, medications, safeguarding of vulnerable adults, recruitment selection and business continuity.

Updated 10 February 2024

About the service:

N1C is a domiciliary care agency providing personal care. The service provides support to adults with dementia, physical disabilities and those who require support with mental health. At the time of our inspection there were 5 people using the service.

People’s experience of the service and what we found:

We identified shortfalls related to the governance of the service. The managerial quality audits were not carried out regularly. These included audits of care plans, risk assessments, medicines competency as well as staff personnel records. Such audits were needed to ensure the care was provided effectively, safely and in line with the current national guidelines.

We identified that some improvements were needed to people’s care plans and risk assessments to ensure these were always person-centred. Nevertheless, we noted that due to the small size of the service, staff knew people’s needs and preferences. This was because people were supported by the same staff who new them well.

People were protected from the risk of harm or abuse. Staff told us they had received regular safeguarding training and were able to explain their understanding of identifying and reporting safeguarding concerns. The registered manager demonstrated knowledge of how to handle safeguarding concerns appropriately and the relevant agencies to notify including CQC.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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 Support

People told us they were encouraged to maintain independence and had choice over their care.

Right Care

People and their family members told us they were happy with the level of care they received. Staff provided person-centred care and promoted people’s dignity, privacy and human rights.

Right Culture

People and their families said they felt able to raise concerns with their carers and the registered manager. They said, their concerns were listened to and acted upon.

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

Rating at last inspection:

The last rating for this service was Good (published 6 April 2018).

Why we inspected:

This inspection was prompted by a review of the information we held about this service.

Recommendations

We have made a recommendation about the auditing of staff training records.

Enforcement

We have identified a breach in relation to the governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.