Naidcare

Naidcare is a domiciliary care service providing the regulated activity of personal care to people living in their own homes, flats, and specialist housing schemes. At the time of our inspection there were a total of 16 people using the service across Essex and Staffordshire. This included 2 people who were living in a ‘supported living’ setting, so that they can live as independently as possible.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted.

'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The provider demonstrated an understanding of ‘Right support, right care, right culture.’ Although very few people with a learning disability and autistic people were supported by the service, systems were in place to ensure their needs were met in a person-centred manner.

Right Support:

Staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.

Staff focused on people's abilities and promoted what they could do.

Visits were organised, monitored, and delivered safely through effective use of an electronic call monitoring system.

Staff enabled people to access specialist health and social care support in the community.

Staff supported people with their medicines in a way that achieved the best possible health outcome.

Right Care:

Staff were described as kind and caring. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People's care and support plans reflected their range of needs.

Staff received appropriate training, including specialist training on how to support autistic people and people with a learning disability.

Right Culture:

People's quality of life was enhanced by the service's culture of improvement and inclusivity.

Staff turnover was very low, which supported people to receive consistent care from staff who knew them well.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency and respect.

There had been improvements made at the service since the last inspection, and the registered manager was committed to continuous development and improvement to ensure lessons were learned.

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 1 October 2022]

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.

At our last inspection we recommended that the provider’s arrangements to investigate safeguarding concerns required improvement. At this inspection we found the provider had acted on our recommendations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 of Safe and Well-Led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. 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 Naidcare on our website at www.cqc.org.uk.

Follow up

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

Naidcare is a domiciliary care service providing the regulated activity of personal care. The service provides support to people living in their own house, flat or other specialist housing accommodation. At the time of our inspection there were a total of 19 people using the service across Essex and Staffordshire.

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

The provider’s governance arrangements did not provide assurance the service was well led, and regulatory requirements were not being met. Quality assurance systems were not robust and had not identified the shortfalls we found during our inspection. Improvements were required relating to recruitment checks, some aspects of medicines management and carrying out robust internal investigations following safeguarding concerns. We have made recommendations about recruitment practices and the completion of internal investigations.

People were protected by the provider’s prevention and control of infection practices and arrangements. People said they felt safe and had no concerns about their safety or wellbeing. People told us the service was well managed and staff stated they felt supported by the registered manager.

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 requires improvement [published May 2021]. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to staffing and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Naidcare provides personal care to people living in their own houses, flats and specialist housing. This is a domiciliary care service and primarily provides a service to older people, older people living with dementia or who may have a physical disability. At the time of inspection there were 21 people using the service.

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

Risks for people were identified and recorded in relation to their care and support needs but information relating to how risks to a person’s wellbeing and safety were to be mitigated were not recorded. Minor improvements were still required relating to the service’s recruitment practices and procedures. Staff had not been assessed as competent before being involved in the administration of medicines. The manager was not formally registered with the Care Quality Commission.

There was a low incidence of safeguarding concerns and these were recorded and investigated. There were suitable numbers of staff to keep people safe and meet their needs. People received their medicines and accurate records were maintained. People were protected by the prevention and control of infection.

Staff received an induction, supervision and support in their role and areas of responsibility. People's healthcare needs were promptly met, and staff supported them with any nutritional and hydration needs. 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.

People state the service is consistently well-led. Improvements have been made in relation to the service’s governance arrangements. The service involves people, relatives and staff in a meaningful way. The provider worked alongside other agencies to meet people's needs.

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 requires improvement (published 10 October 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an announced comprehensive inspection of this service in August 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in relation to person centred care, safe care and treatment, good governance and staffing.

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 of Safe, Effective, Responsive 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 remained unchanged. 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 Naidcare on our website at www.cqc.org.uk.

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.

Naidcare provides personal care to people living in their own houses, flats and specialist housing. This is a domiciliary care service and provides a service to older people, people living with dementia and people who have a physical disability. At the time of inspection there were 32 people using the service.

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

Risk assessments were in place relating to people’s moving and handling needs and environmental risks. However, other risks relating to people’s health and wellbeing had not been considered. Medication practices were not safe and required improvement. Recruitment practices were not as robust as they should be to make sure the right staff were recruited. Enough numbers of staff were available to support people who used the domiciliary care service, but people told us there were occasions when staff were late. Findings from this inspection showed lessons were not always learned and improvements made when things go wrong.

People told us they were safe. Suitable arrangements were in place to protect people from abuse and avoidable harm. Staff understood how to raise concerns and knew what to do to safeguard people. People were protected by the prevention and control of infection.

Improvements were required to ensure staff were appropriately trained, specifically in relation to medication and manual handling. Staff received an induction and regular supervision. People received enough support to have their nutritional and hydration needs met. People were supported to access healthcare services and receive ongoing healthcare support. The service worked with other organisations to enable people to receive effective care and support. 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.

People’s comments about the quality of care and support received was variable. People’s comments suggested staff primarily focused on tasks rather than the people themselves. People told us staff knew what was expected of them in relation to the tasks to be completed but spent little time engaging in meaningful conversation and pleasantries. People told us they wanted staff to spend time with them, sit and talk, but this rarely happened.

Not all people using the service had a support plan in place detailing all aspects of a person's individual circumstances and needs. The service is not compliant with the Accessible Information Standard to ensure it meets people’s communication needs.

People and those acting on their behalf were confident to raise issues and concerns and felt listened to. At the time of this inspection, no-one was requiring end of life care support. However, the management team knew how to seek support from the local palliative care team.

Though no-one using the service was harmed or at significant risk, effective governance and quality assurance arrangements were not in place to assess, monitor and improve the quality and safety of the service provided.

We have made a recommendation about staff recruitment practices.

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

The last rating for this service was ‘Good’ (published June 2016)

Why we inspected

This was a planned inspection based on the service’s 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.