Nissi Home Care

Nissi Home Care is a domiciliary care service that provides care and support to a wide range of people with varied needs, including older people, younger adults, people with dementia and people with a physical disability. The service also provides end of life care and support to a number of people. At the time of our visit 37 people living in several parts of London were using the service.

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

Whilst people and their relatives told us staff were kind, caring and competent, the service did not complete all the required recruitment checks appropriately before staff were employed.

Staff had the right training and were competent to administer people’s medicines as prescribed. The service identified risks associated with people’s care and health needs and provided guidance for staff to reduce those risks. People felt safe and were protected from abuse. Staff were aware of their responsibilities to raise concerns if they felt a person was being abused. The service understood the importance of infection prevention and control and had measures in place to keep people safe.

The service had systems in place to monitor and improve the quality of service. However, existing audits had not identified the concerns we found during this inspection. The registered manager reacted promptly and started making improvements.

There was a positive and inclusive culture at the service where people and their relatives felt valued and respected. People and their relatives were able to express their views which staff acknowledged. Staff felt supported in their roles and provided care that was tailored to meet people’s individual needs. The service worked in partnership with other organisations to support people and their relatives in their best interests.

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 25 October 2018).

Why we inspected

We undertook this focused inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

This report only covers our findings in relation to the Key Questions Safe and Well-led. 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 good to requires improvement. 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 Nissi Home Care on our website at www.cqc.org.uk.

Enforcement

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 a breach in relation to safe recruitment of staff.

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.

Nissi Home Care is a domiciliary care agency. It is registered to provide personal care to older people, younger adults, people with dementia, people with a mental health condition, a learning disability or autistic spectrum disorder, an eating disorder, a physical disability, and sensory impairment.

Not everyone using Nissi Home Care receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of inspection, the service was providing personal care to three people living in their own houses and flats in the community.

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.

People and relatives told us they trusted staff and felt safe with them. Staff knew their role in identifying and reporting abuse and poor care and knew how to escalate concerns. The provider maintained detailed risk assessments that gave information on risks to people and measures staff needed to take to ensure safe care. Staff had a good understanding of risks to people and how to meet their needs safely. There were systems in place for safe medicines management. Suitable and sufficient staff were recruited to ensure people at risk were supported by staff that were safe. Staff were trained in infection control and followed safe infection control practices to prevent the spread of infection. There were systems in place to report, record, investigate incidents and learn lessons from them.

People’s needs were assessed and they told us staff met their individualised needs. Staff were provided with regular support and sufficient training to do their jobs effectively. People told us their dietary needs were met. The registered manager supported people to access healthcare services when requested. Staff sought people’s consent before providing care and people told us staff gave them choices and encouraged them to make decisions.

People and relatives told us staff were caring and treated them with dignity and were respectful. Staff were trained in dignity and privacy and understood the importance of providing dignified care. People’s cultural and religious needs were recorded and met. Staff encouraged people to remain as independent as possible.

People’s care plans were comprehensive and personalised. Staff knew people’s likes and dislikes and were trained in person-centred care. People told us they received personalised care. Staff supported people in accessing community venues and activities when requested. The provider involved people and relatives where necessary in the care planning and reviews. People and relatives knew how to raise concerns but told us they had not made complaints. There were systems in place to support people with end of life care needs.

The registered manager had a good understanding of the needs of people who used the service and their responsibilities in notifying us of incidents. There were monitoring, auditing and evaluating systems in place to improve the quality and safety of the service.