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Nexxus Care (Staffordshire) Good

Reports


Inspection carried out on 4 March 2020

During a routine inspection

About the service

Nexxus Care (Staffordshire) is a domiciliary care service that was providing personal care to 86 people living in their own homes at the time of the inspection. People could be supported with a range of support needs such as people living with dementia, those who needed support with their mental health, older and younger adults, people with a learning disability and a physical and/or sensory impairment.

The service was split into two parts; enablement and domiciliary care. For those receiving enablement support, this was short, intensive package of care, to support people when discharged from hospital. Those in receipt of a domiciliary care needed longer term support to help them remain in their own homes.

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

People were very satisfied with the service provided by the agency and received safe and effective care and support to meet their individual needs.

People were protected from harm by staff who were confident to recognise, and report abuse, and processes were in place to support staff to share concerns. Senior staff worked efficiently and professionally with external professionals to ensure people were safeguarded.

People, who required support to manage their medicines received appropriate and safe support and risks to people’s health and wellbeing were continually identified and reviewed. Risks were proactively managed.

People received largely consistent support from a staff team who were well trained and knowledgeable to meet individual needs. Staff provided a flexible and responsive service to accommodate people's changing needs.

Staff were safely recruited to ensure they were appropriate, and a good match, to support people who used the service. Staff were well supported by managers and colleagues to deliver good care.

People’s needs were assessed and documented, and care plans were detailed so staff could deliver effective support based upon individual needs. People’s individual cultural, social and dietary needs were assessed and supported effectively and in line with their preferences.

Staff worked with health and social care professionals proactively to ensure consistency and ensure people received appropriate and safe support.

Staff were kind, caring and respectful, promoting people’s privacy, dignity and encouraging their independence.

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.

Staff sought people’s consent before supporting them and decisions about people’s care and treatment were made in line with law and guidance.

People knew how to raise a concern and felt listened to by staff and the registered manager. Information could be made available in different formats to make it accessible. Staff had regular opportunities to share their views about the service.

People, relatives and social care professionals felt the service was well managed. Systems and processes were in place to enable the provider, and the registered manager, to monitor the quality and effectiveness of the service.

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

Why we inspected

This was a planned inspection

Rating at last inspection

The last rating for this service was Requires Improvement (report published December 2019). At this inspection the service is now rated as good.

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.

Inspection carried out on 23 January 2019

During a routine inspection

About the service:

Nexxus Care (Staffordshire) is a domiciliary care service that was providing personal care to 79 people living in their own homes at the time of the inspection. People had a range of support needs such as people living with dementia or those who needed support with their mental health, older and younger adults, people with a learning disability and a physical and/or sensory impairment.

The service was split into two parts; reablement and domiciliary care. For those receiving reablement support, this was short package of care, typically lasting up to six weeks, to help people be more independent and to make improvements following coming home from hospital. Those in receipt of a domiciliary care needed longer term support to help them remain in their own homes.

People’s experience of using this service:

Systems were not always effective at identifying omissions and the monitoring of people’s experience of care was inconsistent. Notifications to the CQC were not always submitted as required. Some staff were confused about the management structure, however staff who did know the registered manager felt they were approachable.

There were not always enough staff which mean staff were having to cover additional calls. People liked their regular staff and felt treated with kindness and respect; however, people were not always supported by the same staff team. Improvements were needed in ensuring recruitment information was available.

People were supported to take their medicines but improvements were needed to ‘as and when required’ medicines and the recording of nutritional supplements.

There was mixed feedback about staff training, although plans were already in place to make the necessary improvements. There was also mixed feedback about how people were supported with their food and drinks.

People were supported to access other health professionals but improvements were needed to the information available to staff about people’s specific health conditions.

Appropriate assessments were not in place to ensure people had the mental capacity to make certain decisions, although people did not raise concerns about being offered choices.

Care plans did not always contain information about people’s end of life preferences and the reviews of people’s care plans was inconsistent.

People were supported to retain and regain their independence. People felt able to complain, and complaints were responded to.

The service worked in partnership with other organisations. The provider was proactive in trying to improve the service and following feedback action was taken and plans were put in place to take further actions.

People were protected as staff understood their safeguarding responsibilities and following infection control procedures.

Rating at last inspection:

This is the first time the service has been inspected since registration.

Why we inspected:

This was a routine inspection planned on when the service was registered.

Recommendations:

• We have recommended staff are supported to improve their understanding of the Mental Capacity Act 2005.

Enforcement:

Action we told the provider to take can be seen at the end of the full version of the report.

Follow up:

We will continue to monitor the service and check improvements have been made at our next inspection.