Nurseplus UK - Bournemouth

Nurseplus UK is a domiciliary care agency provide care to people in their own home. 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. At the time of the inspection, eight people were using the service.

People’s experience of using this service and what we found

Improvements had been made at the service since our last inspection. Medicines were managed safely; an electronic system had been introduced which alerted the manager when medicines were not administered for any reason so this could be reviewed and acted upon immediately. Call times were arranged so medicines could be administered as prescribed.

We made a recommendation at our last inspection about staff travel to visits and staying the agreed times. We found this had improved and there were sufficient numbers of suitable staff to support people to stay safe and meet their needs. One relative said, “We have had the same staff continuity and it’s consistently good.”

Relatives told us people felt safe and knew staff well. One relative said, “[staff member] completely put [person] at ease, I can rest when they are here knowing [person] is well looked after.”

Staff knew how to safeguard people from abuse.

People were protected by the prevention and control of infection. Lessons were learned when things went wrong.

People spoke positively about the management of the service. The management was open and honest throughout the inspection and had a clear understanding of the duty of candour.

Quality performance was managed. People, relatives and staff were engaged in the management of the service and feedback was continuously sought to learn and improve care. The service worked in partnership with other agencies.

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 27 September 2019) and 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. We made recommendations about staffing and quality assurance systems within the service. At this inspection we found improvements had been made and the provider was no longer in breach of regulations and our recommendations had been acted upon.

Why we inspected

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Nurse Plus UK is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of this inspection the service was providing care and support to 45 people.

People’s experience of using this service and what we found

The management and administration of people’s medicines was not always safely undertaken.

We saw, and people told us, they received care from staff who knew their needs well and ensured that they felt safe and well cared for. We have made a recommendation about how staff visits to people are planned to ensure they have the required time to spend with people and enough time to travel between visits.

People and staff felt the service was well led. We have recommended that systems for auditing and oversight of the service are reviewed.

People were supported by staff who provided flexible, responsive care. Staff recruitment checks ensured staff were suitable to work with people in a care setting. Staff induction, on-going training and support enabled them to carry out their roles effectively.

People told us they felt listened to and consulted when planning and agreeing what care and support they needed. We found that people were supported to access appropriate healthcare where necessary to maintain their health and wellbeing.

Risks to people were assessed and regularly reviewed. Staff understood the actions needed to minimise the risk of avoidable harm including the prevention of avoidable infections.

People knew how to make a complaint and felt confident they would be listened to if they needed to raise any concerns.

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 did not always support this practice and we have made a recommendation regarding mental capacity assessments and best interest decisions.

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

Enforcement

We have identified breaches in relation to the management and administration of medicines at this inspection. Please see the action we have told the provider to take at the end of this report.

Rating at last inspection

The last rating for this service was good (published 8 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Nurse Plus and Carer Plus (UK) Limited provides personal care and support to people who live in their own homes and also provides a healthcare recruitment service. The latter function of the agency was not included as part of the inspection as it does not fall within scope of the Health and Social Care Act 2008 and associated Regulations. At the time of our inspection the agency was providing personal care and support to approximately 50 people in their homes.

A registered manager was in post at the time of the inspection. 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.

People’s care and support needs were met with people saying care workers were kind, caring and respectful.

Staff had been trained in safeguarding adults and were knowledgeable about the types of abuse and how take action if they had concerns.

Accidents and incidents were monitored to look for any trends where action could be taken to reduce likelihood of recurrence.

Robust recruitment systems were being followed to make sure that suitable, qualified staff were employed in the right numbers for effective running of the service.

Where assistance with, or administration of medicines formed part of a person’s care package, this was managed safely.

The staff team were suitably trained to provide them with the knowledge and skills for them to fulfil their role effectively.

Staff were well supported through supervision sessions with a line manager, and an annual performance review.

Staff and the manager were aware of the requirements of the Mental Capacity Act 2005 and acted in people’s best interests where people lacked capacity to consent.

People and staff were very positive about the standards of care provided. People were treated compassionately as individuals, with staff knowing people’s needs.

People’s care needs had been thoroughly assessed and care plans put in place to inform staff of how to care for and support people. The plans were person centred and covered all areas of people’s needs. The plans we looked at in depth were up to date and accurate.

There were complaint systems in place and people were aware of how to make a complaint.

The service was well led with a positive, open culture.

There were systems in place to audit and monitor the quality of service provided to people.

Nurse Plus and Carer Plus Limited was registered to provide personal care and nursing care. The manager advised us that the agency was only supplying nurses to hospitals and care homes providing nursing at the time of the inspection. As this was not a regulated activity this inspection focused only on the provision of personal care in a person's own home.

At the time of the inspection the agency was providing personal care for approximately 80 people. We talked with one person who, with their spouse, used the service, who told us 'It's wonderful. We're very happy, and the girls are all very nice.'

We reviewed care records for four people and found that they experienced safe and effective care because care plans were based on their assessed needs.

People were protected from the risk of poor management of their medication because there were effective systems in place.

There were effective systems in place to ensure people were safe because staff were subject to rigorous recruitment procedures and a thorough induction.

People benefited from safe care and support because the provider monitored the quality of service that people received.

During this inspection we looked at comment cards and spot check cards from people who receive care from Nurse Plus. All the comments that had been made said the people were very happy with the service that they received from Nurse Plus.

People who used the service commented care workers treat them with dignity and respect and provide all the help and care they needed.

Comments about the service included "Very happy with the carers job performance, thank you", "Staff are hard working and use their own initiative to ensure high standards are met", "They are brilliant, they work well with all people" and' They are friendly, polite, helpful, organised, professional and they communicate well with the person".

We spoke with members of staff and they all stated the agency had provided thorough training and good support in order for them to provide effective personal care.